Clinical Analysis Of Laparoscopic Treatment Of Tubal Infertility Caused By Tubal Distortion

Infertility is to point to living together after marriage, having a normal sex life without contraceptiion a year, without pregnancy.It is a relatively common disease, and the etiology is complex and diverse.Most scholars believe that the fallopian tube abnormalities is one of the main factors leading to female infertility, and infertility caused by tubal distortion accounts for about30%to40%of patients with tubal infertility.The tubal distortions caused by chronic salpingitis,tubal phlogistic surrounding tissue,congenital tubal abnormalities change the normal walking of the fallopian tube,reducing its peristaltic fuction and affect the flow of tubal fluid,thus affecting the transport of ova and sperm and cause infertility.At present, laparoscopy is the gold standard for diagnosis of tubal disease. In terms of treatment, laparoscopic surgery as a routine treatment for tubal infertility,it can make part of patients conceive naturally.For ones who have ethical concerns and in patients with mild to moderate tubal disease,tubal plastic surgery is more acceptable.ObjectiveBy undergoing laparoscopic tubal plastic surgery to tubal infertility patients,intraoperative assessment of tubal morphology and its function,to analyze the outcome of pregnancy and degree of tubal distortion of its impact.To investigate the clinical value of laparoscopic treatment of tubal infertility caused by tubal distortion and the relationship between postoperative pregnancy rate and the degree of tubal distortion,providing guidance for the treatment of infertility caused by tubal distortion.MethodsChose268cases who have had laparoscopic tubal plastic surgery in Gynecological ward two of Third Affiliated Hospital of Zhengzhou University, intraoperative assessment of situation of pelvic adhesions and fallopian tubes.There are77cases who were caused by simple distorted tubal infertility of all.To operate tubal plastic surgery according to intraoperative findings.Try to sretch the fallopian tubes to restore its normal shape,and record the minimum angle of the distortion.Patients are divided into the minimum angle group<45°,group45°～90°and group90°～145°.Then eliminate the distortion by electrocantery.Conduct hysteroscopy for uterine and tubal cannulation for tubal patency.Patients who have HCG-positive and the gestational sac under ultrasound can be diagnosed pregnant. According to statistics of clinical data and postoperative follow-up6～24months data, analyze the outcome of pregnancy and degree of tubal distortion of its impact by SPSS17.0software,and α=0.05are used as test standard.Results1.The total pregnancy rate after laparoscopic tubal plastic surgery of these268cases are48.9%, with44.4%intrauterine pregnancy rate and4.5%ectopic pregnancy rate.2. There are77patients with simple twisted tube,which account for28.7%of patients with tubal infertility.There are22cases in the group the minimum angle <45°,and5cases got pregnancy after operation.In49cases the minimum angle between45°to90°,24cases of them got pregnancy.In6cases the angle between90° to145°,3cases got pregnancy.Comparing the pregnancy rate of the group the minimum angle <45°and group minimum angle45°～90°,the result of Pearson Chi-Square is0.037. Similarly,comparing the pregnancy rate of the group the minimum angle45°～90°and group minimum angle90°～145°,the result of Pearson Chi-Square is0.962.3.There are32cases got pregnant in the77patients with simple twisted tube after laparoscopic tubal plastic surgery,in which30cases had intrauterine pregnancy--25cases are pregnant in six months after surgery,6cases in the seventh month to the twelfth month,and1case in the thirteenth month to the twenty-forth month.Conclusions1.By laparoscopic tubal plastic surgery to restore the normal shape of fallopian tube is an effective method of treatment of infertility,especially for those cases the minimum angle>45°.2.The peak of pregnancy appears in the six months after surgery.And the composition of pregnancy declines with time.