国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2016, Vol. 35 ›› Issue (3): 187-190.

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输卵管外科手术在治疗输卵管性不孕中的应用

陈亚琼，陈俊，侯海燕，董渠龙   

  1. 300162 中国人民武装警察部队后勤学院附属医院妇产科（陈亚琼，陈俊，侯海燕，董渠龙）；天津中医药大学（陈俊，侯海燕）；中国医学科学院 北京协和医学院（侯海燕）
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2016-05-15 发布日期:2016-05-15

Application of Tubal Endoscopic Surgery in Treatment of Tubal Infertility

CHEN Ya-qiong, CHEN Jun, HOU Hai-yan, DONG Qu-long   

  1. Department of Obstetrics and Gynecology, Affiliated Hospital of Logistics College of Chinese People′s Armed Police Forces, Tianjin 300162, China（CHEN Ya-qiong, CHEN Jun, HOU Hai-yan, DONG Qu-long）; Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China（CHEN Jun, HOU Hai-yan）; Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China（HOU Hai-yan）
  • Received:1900-01-01 Revised:1900-01-01 Published:2016-05-15 Online:2016-05-15

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摘要： 输卵管因素引起的不孕（简称输卵管性不孕）是女性不孕的首要原因，主要包括近端输卵管梗阻、输卵管绝育术和输卵管远端粘连、闭锁、积水。在辅助生殖技术占据生殖医学主导地位的今天，生殖手术在治疗输卵管性不孕中的地位并未改变。综合考虑患者的年龄、卵巢储备功能、术后输卵管功能、男方精液参数等指标后有指征地实施个体化生殖手术，不仅可以取得较满意的临床妊娠率和活产率，还可以恢复患者多次自然受孕的能力，这与我国现行生育政策更为贴合。针对输卵管病变部位的不同，采取的术式也各异，主要有近端输卵管吻合术、输卵管导丝介入术、中段输卵管吻合术、输卵管粘连分解术、输卵管伞端成形术、输卵管造口术、输卵管切除术和输卵管结扎术。

关键词: 不育, 女（雌）性, 输卵管疾病, 输卵管阻塞, 绝育, 输卵管, 输卵管腔镜手术

Abstract: Tubal factors are the most infertile causes in female infertile women, including the proximal tubal obstruction, tubal sterilization, and distal fallopian adhesion, atresia and hydrosalpinx. Although assisted reproductive techniques have dominated in reproductive medicine at present, the reproductive surgery still plays a irreplaceable role. Comprehensively considering the age, ovarian reserve, tubal function after reproductive surgery and the partner′s semen parameters, the individualized reproductive surgery can be performed in those patients with surgery indications. The endoscopic surgical treatment not only usually brings satisfactory outcomes in the clinical pregnancy rate and the live birth rate, but also restores the potence of natural fertilization in some patients, which meets the fertility policy of China. Different procedures of endoscopic surgery , according to the different tubal lesions, can be selected, mainly including the proximal fallopian tube anastomosis, the tubal catheterization, the middle fallopian tube anastomosis, tubal adhesiolysis, fimbrioplasty, salpingostomy, salpingectomy and ligation.

Key words: Infertility, female, Fallopian tube diseases, Fallopian tube obstruction, Sterilization, tubal, Tubal endoscopic surgery