本文選題：不孕癥 + 宮腔鏡�。� 參考：《大連醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：探討宮腔鏡聯(lián)合腹腔鏡在不孕癥方面的臨床應(yīng)用情況。 方法：在從2009年3月至2012年3月來我院(大連醫(yī)科大學(xué)附屬2院）就診行宮腹腔鏡聯(lián)合檢查的不孕患者中隨機(jī)選取80例，根據(jù)檢查和診斷的情況采用相應(yīng)的手術(shù)方法進(jìn)行治療，對所有患者的臨床資料進(jìn)行回顧分析。 結(jié)果：1、80例不孕患者中原發(fā)性不孕31例（38.75%），繼發(fā)性不孕49例（61.25%）；宮腹腔鏡聯(lián)合檢查診斷結(jié)果與應(yīng)用傳統(tǒng)的HSG檢查法檢查出的結(jié)果相比，其差異明顯，具有統(tǒng)計(jì)學(xué)意義。 2、經(jīng)宮腹腔鏡聯(lián)合治療后，80例患者中，治療前有100條輸卵管堵塞，60條通暢；治療后12條堵塞，，148條通暢，輸卵管疏通率達(dá)92.5%，與術(shù)前相比差異顯著。 3、不孕患者的HSG與腹腔鏡下通液結(jié)果進(jìn)行比較，以后者作為標(biāo)準(zhǔn)，結(jié)果顯示HSG診斷的假陽性率為19.42%，假陰性率48.42%，特異度80.58%，靈敏度51.58%，正確指數(shù)為67.84%。 4、術(shù)后對80例患者進(jìn)行隨訪，1年內(nèi)有33例受孕（其中32例為宮內(nèi)孕，1例為宮外孕），妊娠率達(dá)41.25%；1~2年內(nèi)有17例受孕（其中16例為宮內(nèi)孕，1例為宮外孕），妊娠率達(dá)21.55%。 結(jié)論：在臨床診斷和治療不孕癥的過程中，將宮腔鏡與腹腔鏡聯(lián)合應(yīng)用是一種十分可行并且有效的方法，宮腹腔鏡的聯(lián)合應(yīng)用將二者各自的優(yōu)點(diǎn)結(jié)合起來，達(dá)到了協(xié)同作用，使這種方法具有創(chuàng)傷小、恢復(fù)快、術(shù)后并發(fā)癥少、患者負(fù)擔(dān)減輕等優(yōu)點(diǎn)，在檢查和診斷不孕癥以及改善不孕患者的妊娠情況方面具有重要意義，臨床應(yīng)用前景很好。
[Abstract]:Objective: to investigate the clinical application of hysteroscopy combined with laparoscopy in infertility. Methods: from March 2009 to March 2012, 80 infertile patients who were admitted to our hospital (second affiliated Hospital of Dalian Medical University) for combined hysteroscopy and laparoscopy were randomly selected and treated by corresponding surgical methods according to the examination and diagnosis. The clinical data of all patients were analyzed retrospectively. Results among 80 infertile patients, 31 had primary infertility and 49 had secondary infertility. The results of combined hysteroscopy and laparoscopy were significantly different from those of traditional HSG. (2) in 80 patients with hysteroscopy combined with laparoscopy, there were 100 tubal blockages (60 patency) before treatment and 148 tubal blockages (148 patency) after treatment, and the fallopian tube dredging rate was 92.5% (P < 0.05), which was significantly different from that before treatment. 3. The results of HSG in infertile patients were compared with those of laparoscopy. The results showed that the false positive rate of diagnosis of HSG was 19.42, the false negative rate was 48.42, the specificity was 80.58, the sensitivity was 51.58, and the correct index was 67.84. (4) 80 cases were followed up after operation, 33 cases (including 32 cases of intrauterine pregnancy, 1 case of ectopic pregnancy), 17 cases (16 cases of intrauterine pregnancy, 1 case of ectopic pregnancy and 21.55%) were pregnant within 1 ~ 2 years after operation. Conclusion: in the process of clinical diagnosis and treatment of infertility, the combination of hysteroscopy and laparoscopy is a very feasible and effective method. The combination of hysteroscopy and laparoscopy can combine their respective advantages and achieve a synergistic effect. This method has the advantages of less trauma, faster recovery, less postoperative complications and less burden on patients. It is of great significance in the examination and diagnosis of infertility and the improvement of pregnancy status of infertile patients. The clinical application prospect is very good.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R711.6

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