| Objective:The incidence of infertility is on the rise.More and more Childbearing age couples arepagued by infertility. Lots of factors can lead to infertility,and fallopian tube related factorsaccounted for about30%.The infertility incidence caused by tubal factor is increasing yearby year,and tubal factor is gradually becoming the main factor of infertility. In recent years,gynecological endoscopic techniques and assisted reproductive technology are widelyapplied in the treatment of oviduct infertility.This topic proposed by Taian Central Hospital January2004December2004hysteroscopic techniques, January2007-December2007laparoscopic technology andJanuary2009-December2009Application Palace intraperitoneal endoscopic treatment oftubal obstruction infertility patients260cases were retrospectively analyzed to explore thehysteroscopy, laparoscopy, laparoscopy combined in the treatment of tubal obstructioninfertility advantages, limitations, and pregnancy rate and analyzed.Materials and Methods:1.General materialIn Tai’an Central Hospital for treatment of tubal obstruction infertility patients260cases were divided into three groups. GroupI: in2004January60cases of-2004years forthe December application of hysteroscopy; groupⅡ: treatment of80patients treated in2007January-2007year in December by laparoscopy; group Ⅲ: January2009-December2009hysteroscopy were120cases of laparoscopic treatment. Statistics fallopian tuberecanalization rate of the three groups and each group of intrauterine and ectopic pregnancy,compared hysteroscopy, laparoscopy in patients with tubal obstruction infertility treatmentvalue.260patients over2years in duration of infertility, preoperative woman’s menstrualrules, normal ovarian function, excluding the history of tuberculosis and tuberculin skintest-positive patients by hysterosalpingography (HSG) confirmed the presence of tubalobstruction (the surgery confirmed the existence of other factors, such as intrauterineadhesions (IUA), endometrial polyps (TCRP) and uterine mediastinum (TCRS), etc., and tubal fimbria water than3cm were excluded, while there were not endometriosisexcluded). Male semen examination was normal, heart, liver, kidney and other vital organfunction was normal.2. MethodStatistical treatment group hysteroscopy, laparoscopy treatment gr oup, Laparoscopycombined therapy group after tubal recanalization rate and intrauterine and ectopicpregnancy, and the results were compared.Statistical:Using the SPSS18.0statistical package for processing, based on an analysis of needs,re-sort the data using tables and charts for descriptive statistical analysis. Categoricalvariables using X2test or exact. All tests were two-sided test, let α=0.05. Mapping part ofthe selection EXCEL2003software.Results:1. Gynecologic endoscopic treatment of three groups of patients after a menstrualhysterosalpingography angiography (HSG) recanalization rate was26.92%,36.43%,70.83%, Group III is higher than the former two groups endoscopic treatment of threegroups of patients after a menstrual hysterosalpingography angiography was statisticallysignificant (P <0.05), Proximal tubal group I (interstitial the isthmus) recanalization ratewas significantly higher than the distal tubal group II distal recanalization rate is higherthan the proximal (interstitial isthmus).2. After225patients were followed up, endoscopic treatment of three groups ofpatients after a menstrual hysterosalpingography angiography,35patients were lost tofollow-up time of24months after surgery, ectopic pregnancies are tubalpregnancy,postoperative intrauterine and ectopic pregnancy rate were13.73%,5.88%;13.51%,6.76%;27.00%,8.00%,16cases of ectopic pregnancies are tubal pregnancy.3. Three groups after2years,22years old-29years old,30years old-35years old,36years old-38years age pregnancy rate accounted for the ratio of the number of patients(n%) were28.57,9.52,0;27.50,10.71,16.67;43,64,26.32,14.29. Overall pregnancy rate ra-tio of the total number of patients (n%) is:34,96,17.24,13.33. Three gestational agescompared to the situation there was significant difference (P <0.05)4.Three groups of patients after treatment, March-June July-December,13-18months,19-24months pregnancy (n%), respectively:9.80,10.81,17.00;8.70,7.58,15.66;2.38,1.64,4.29;0.00,1.67,2.99. Total ratio:13.33,11.28,2.89,1.79. Pregnancy rate showed adecreasing trend over time, a year after pregnancy rate has fallen markedly. Four time segments compared to the situation of pregnancy was significantly (P <0.05)Conclusion:1. Hysteroscopic treatment can be more intuitive, accurate observation of the uterinecavity, proximal tubal obstruction better therapeutic effect. Laparoscopic treatment on theoutside of the fallopian tube and tubal adhesions, better understanding and treatment ofdistal obstruction. Laparoscopy combined treatment can play to the advantages ofhysteroscopic and laparoscopic tubal distal and proximal processing.2.Hysteroscopy, laparoscopy, laparoscopy combination therapy within six monthsafter pregnancy rate highest.3.Tubal obstruction infertility patients after surgery pregnancy and inverselyproportional to age, the younger the pregnancy rate is higher, the greater the pregnancy rateis lower.4.Gynecologic endoscopic treatment of tubal obstruction infertility patients within sixmonths of the highest pregnancy rate, pregnancy rate gradually decreased over time, themost obvious one year after the fall... |
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