腹腔镜电凝打孔术治疗耐氯米芬多囊卵巢综合征不孕43例疗效分析

目的:探讨腹腔镜下卵巢表面电凝打孔术对耐氯米芬(CC)多囊卵巢综合征(PCOS)所致不孕症患者的疗效。方法:对耐氯米芬的PCOS不孕患者43例,行腹腔镜下卵巢表面电凝打孔术。术后随访3~12个月。观察手术前后血清黄体生成素(LH)、卵泡刺激素(FSH)、睾酮(T)、雌二醇(E2)、泌乳素(PRL)水平变化,卵巢体积及窦卵泡数的变化,术后月经和排卵情况、妊娠率及流产率。结果:术后LH、T、LH/FSH、PRL水平、卵巢体积、窦卵泡数均较术前明显降低(P<0.01),而FSH、E2术前、术后差异无显著性(P>0.05),月经情况明显改善,术后排卵率为93.0%(40/43),妊娠率为58.1%(25/43),流产率为16.0%(4/25)。结论:腹腔镜下卵巢表面电凝打孔术对于耐CC的PCOS不孕患者具有高排卵率和妊娠率以及低流产率的疗效。同时,具有创伤小、恢复快、并发症少的优点,是治疗耐CC的PCOS不孕患者的有效手段。

Therapeutic Effect of Laparoscopic Ovarian Drilling on 43 Patients of Polycystic Ovary Syndrome with Clomiphene- resistance

Objective:To observe the therapeutic effect of laparoscopic ovarian drilling(LOD) on infertile women with clomiphene-resistant polycystic ovary syndrome(PCOS).Methods:43 patients received LOD,and were followed up for 3-12 months.The serum concentration changes of sex hormones as well as the ovary size and the antral follicle counts were recorded.The menstrual pattern and ovulation changes,the pregnancy outcome were evaluated.Results:LH,T,PRL serum levels and LH/FSH ratio as well as the ovary size,the antral follicle counts showed a significant reduction(P<0.01)after LOD.The menstrual pattern improved distinctly.The spontaneous ovulation rate,the pregnancy rate and the abortion rate after LOD was 93.0%(40/43),58.1%(25/43) and 16.0%(4/25)respectively.Conclusions:LOD is an effective treatment for infertile women with clomiphene-resistant PCOS,resulting in higher ovulation and conception rate,lower abortion rate without major complications.