宫腹腔镜联合诊断在结核菌素试验强阳性不孕症患者中的治疗价值分析

摘要

目的 探究宫腹腔镜联合诊断在结核菌素试验强阳性不孕症患者中的治疗价值.方法 选取本院2014年6月至2015年6月期间收治的78例结核菌素试验强阳性不孕症患者作为研究对象,按照治疗方式不同将其分为观察组(宫腹腔镜联合诊断治疗,n=39)与对照组(腹腔镜诊断治疗,n=39),对两组诊断结果和治疗效果进行回顾性分析.结果 对照组腹腔结节病例确诊结核结节4例;盆腔结节病例确诊结核结节8例;盆腔炎性疾病10例,其中包括单、双侧输卵管积水和输卵管周围组织粘连、输卵管伞部闭锁及走行异常扭曲等;子宫肌瘤7例;子宫内膜异位7例;多囊卵巢综合征2例,卵巢肿瘤3例;内生殖器发育异常2例;子宫内膜息肉3例;子宫内膜结核5例.观察组腹腔结节病例确诊结核结节2例;盆腔结节病例确诊结核结节7例;盆腔炎性疾病17例,其中包括单、双侧输卵管积水和输卵管周围组织粘连、输卵管伞部闭锁及走行异常扭曲等;子宫肌瘤9例;子宫内膜异位12例;多囊卵巢综合征3例,卵巢肿瘤4例;内生殖器发育异常2例;宫腔镜下检查子宫纵膈3例;子宫粘膜下子宫肌瘤1例;子宫内膜结核8例;子宫腔内粘连4例;子宫内膜息肉15例.术后随访24个月,观察组有效率显著高于对照组(56.41％ 比30.77％),差异有统计学意义(χ2=5.2139,P=0.0224).结论 对结核菌素试验强阳性不孕症患者采用宫腹腔镜联合诊断和治疗,可以显著提高患者妊娠率,值得临床推广应用.%Objective To explore the treatment value of hysteroscopy combined with laparoscopy in the diagnosis of infertility patients with strong positive tuberculin test. Methods 78 cases of infertility patients with strong positive tuberculin test treated in our hospital from June 2014 to June 2015 were selected for the study and divided into observation group (diagnosed and treated with hysteroscopy combined with laparoscopy, n=39) and control group (diagnosed and treated with laparoscopy, n=39). The diagnostic results and therapeutic effects of the two groups were retrospectively analyzed. Results In the control group, 4 cases of tuberculous nodules were confirmed by laparoscopic nodules, and 8 cases of tuberculous nodules were confirmed by pelvic nodules; there were 10 cases of pelvic inflammatory disease, including unilateral or bilateral hydrosalpinx, fallopian tubal surrounding tissue adhesion, fallopian tube atresia and abnormal running distortion; there were 7 cases of uterine fibroids, 7 cases of endometriosis, 2 cases of polycystic ovary syndrome, 3 cases of ovarian neoplasms, 2 cases of internal genital malformations, 3 cases of endometrial polyp, 5 cases of endometrial tuberculosis. In the observation group, 2 cases of tuberculous nodules were confirmed by laparoscopic nodules and 7 cases of tuberculous nodules were confirmed by pelvic nodules; there were 17 cases of pelvic inflammatory disease, including unilateral or bilateral hydrosalpinx, fallopian tubal surrounding tissue adhesion, fallopian tube atresia and abnormal running distortion; there were 11 cases of uterine fibroids, 12 cases of endometriosis, 3 cases of polycystic ovary syndrome, 4 cases of ovarian neoplasms, 2 cases of internal genital malformations, 3 cases of hysteroscopic examination of uterine mediastinum, 1 case of submucosal uterine fibroids, 8 cases of endometrial tuberculosis, 4 cases of intrauterine adhesion, 15 cases of endometrial polyp. The effective rate in the observation group (56.41％) was significantly higher than that in the control group (30.77％), with statistically significant difference (χ2=5.2139, P=0.0224). Conclusion The diagnosis and treatment with hysteroscopy combined with laparoscopy can significantly improve the pregnancy rate of the infertility patients with strong positive tuberculin test, worthy of clinical promotion and application.