| Objective:To explore the etiology, of oviduct infertility caused by laparoscopyin the diagnosis and treatment of oviduct infertility research, and statisticsof the different state of fallopian tube hierarchical levels (I-Ⅳ) patientstreated by surgery after the oviduct after rate, intrauterine pregnancy rateand palace pregnancy rate, provide a reference for future clinicaldiagnosis and treatment.Methods:Selected during October2012to October2011in the other third rateand (or) in our hospital tubal examination lesions with185cases ofinfertility patients as the research object. According to different treatmentis divided into two groups:1, the observation group (100cases) treatedby laparoscopic surgery.2, the control group (85cases) with conventionalopen surgery. Statistical analysis of the leading causes of infertilitycaused by tubal lesion and its postoperative pregnancy rate, rate ofoviduct after; On two groups of patients in perioperative indicators,statistical comparison of postoperative patients with pregnancy rates; Ofdifferent state of fallopian tube and hierarchical levels (I-Ⅳ) in patientswith postoperative tubal visited rate, intrauterine pregnancy rate andpalace pregnancy rates were compared. Using "statistical product and service solutions" test data analysis and statistics software version20.0with P value is less than0.05think there was a significant statisticaldifference.Results:1. To compare two groups of patients with intraoperative andpostoperative situation: on the operation time had no significant statisticaldifference (P>0.05). The intraoperative blood loss, postoperative analexhaust time, hospitalization days and total hospitalization expensesindex comparison, observation group was better than control group, asignificant statistical difference (P <0.05).2. Tubal adhesions around is the main cause of oviduct infertility,accounting for47.02%(87/185) and hydrosalpinx is26.49%(49/185),proximal tubal obstruction was18.37%(34/185) tubal empyema5.40%(10/185) and tubal tuberculosis2.70%(5/185). From the point of thevisited situation of postoperative tubal tubal adhesions around the besteffect was81.70%(71/87), followed by hydrosalpinx accounted for53.06%(26/49), fallopian tubes, empyema accounted for40.00%(4/10),proximal tubal obstruction was20.59%(7/34). The postoperative tubaltuberculosis has no obvious effect of0%(0/5). Statistical analysis ofoviduct infertility patients after surgical treatment of fallopian tube aftersituation, bilateral unobstructed, a total of41cases (22.16%), unilateralunobstructed, a total of37cases (20%), links, and a total of30patients (16.22%), not unobstructed, a total of77cases (41.62%).3. Statistics of oviduct infertility patients24months of pregnancyafter surgery, postoperative cumulative pregnancy,78cases (64cases ofintrauterine pregnancy palace pregnancy in11cases, spontaneousabortion in3). Tubal adhesions around the intrauterine pregnancy rate upto50.57%(44/87), next is the hydrosalpinx45.00%(18/49), proximaltubal obstruction was5.88%(2/34). The fallopian tube empyema andtubal pregnancy rate of tuberculosis are0(0/10),(0/5).4. In patients with diagnosis of64cases of intrauterine pregnancy,after6months pregnant11cases (17.19%),12months pregnant30patients (46.88%),18months pregnant21cases (32.81%).64.06%ofpatients within6months after surgery,96.88%of patients within18months of postoperative pregnancy, and2cases of18months aftersurgery within24months after pregnancy. The cumulative pregnancy rateof oviduct infertility patients postoperative can be found after a scatterdiagram depicting,18months after surgery in patients with cumulativepregnancy rate rise rapidly, after18months increased slowly.5. On two groups identified as intrauterine pregnancy patients (64cases) for postoperative follow-up, respectively for6months,12months,18months and24months for phase points, the two groups of patientswith postoperative pregnancy rate in different historical periods, visiblepostoperative periods intrauterine pregnancy rate in observation group were higher than that of control group, there was a significant statisticaldifference (P <0.05).6. On two groups of patients with preoperative tubal patency ratestatistical comparison can be seen, there was no statistically significantdifference (P>0.05), the rate of two groups of patients withpostoperative tubal visited object visible after postoperative rate ofobservation group was obviously higher than that of control group, therewas a significant statistical difference (P <0.05).7. Status of intraoperative fallopian tube and according to thegrading visible tubal state class Ⅰ fallopian tube in patients withpostoperative after rate up to90.70%(39/43), followed by Ⅱ level ofpatients was73.85%(48/65), Ⅲ level of patients was35.19%(19/54),the lowest level Ⅳ patients was8.70%(2/23).8. To determine the intrauterine pregnancy patients (64cases),palace pregnancy patients (11cases) according to the state ofintraoperative fallopian tube sizing is divided into four levels (Ⅰ-Ⅳ),and for different patients with tubal state classification for intrauterinepregnancy rate and the palace pregnancy rate comparison, the visiblestate of fallopian tube class Ⅰ intrauterine pregnancy rate up to60.47%of patients (26/43), followed by: fallopian tube state class Ⅱ50.77%(33/65) of patients, fallopian tube state class Ⅲ9.26%(5/54) of patients.Palace pregnancy with intrauterine pregnancies, in contrast, patients with tubal state class Ⅲ palace pregnancy rate up to16.67%(9/54), followedby: fallopian tube state class Ⅱ3.08%(2/65), fallopian tube state classⅠ0%(0/34). Tubal state class for Ⅳ patients both intrauterinepregnancy and palace pregnancy were0.9. Patients with tubal state class Ⅰ, Ⅱ intrauterine pregnancy orpalace pregnancy had no significant statistical difference (P>0.05).Tubal class Ⅲ patients with tubal state class Ⅰ, Ⅱ of patients werecompared with both intrauterine pregnancy rate and palace pregnancyrate have a significant statistical difference (P <0.05).Conclusion:1. Around the oviduct infertility in patients with tubal adhesion is themain cause, followed by hydrosalpinx, proximal tubal obstruction,fallopian tubes, empyema. These factors have seriously affected theanatomical structure and the normal function of fallopian tube, which canlead to infertility. From the point of the visited situation of postoperativetubal tubal adhesions around the effect best, tubal tuberculosis has noobvious effect.2. Laparoscopic surgery in the treatment of oviduct infertility has aclear diagnosis, small trauma, less bleeding, good treatment effect, fastrecovery and little pain, low cost of absolute advantage. Laparoscopicdiagnosis and treatment. Both fallopian tubes after rate after surgery andpostoperative intrauterine pregnancy rate were better than that in control group. Thus, laparoscopy is one of the best treatment of oviductinfertility.3. Tubal infertility patients state class Ⅰ, Ⅱ have fertilityrequirements, line after laparoscopic surgery can try natural pregnancy assoon as possible, the success rate is higher. For a state of fallopian tubewith to produce class Ⅲ infertility patients, if the state fair of oviduct,postoperative try natural pregnancy, but its opportunity is tubal state classⅠ, Ⅱ patients significantly decreased, palace pregnancy rates increasedsignificantly. So suggest part of the state class Ⅲ and Ⅳ tubalinfertility patients in line as soon as possible after in vitro fertilization andembryo transfer (IVF-ET) technology.4. Tubal state class Ⅰ, Ⅱ, Ⅲ infertility patients postoperative trynatural pregnancy time limit for18months, the longest natural pregnancyprobability significantly decreased more than18months. Should berecommended to take assisted reproductive technology as early aspossible. |
PDF Full Text Request