腹腔镜卵巢打孔术治疗多囊卵巢综合征远期效果的临床研究

目的:评价腹腔镜卵巢打孔术治疗难治性多囊卵巢综合征(polycystic ovary syndrome,PCOS)的远期疗效。方法:2001年1月至2007年6月为用克罗米芬治疗无效的138例PCOS患者施行腹腔镜卵巢电凝打孔术,观察手术前后FSH、LH、E2、T、PRL的变化,对比手术前后卵巢体积及形态的变化,术后根据基础体温测定和B超监测排卵情况,随访月经恢复正常、受孕和新生儿的情况。结果:随访24～78个月,48例随访60个月以上。术后LH、T较术前明显降低(P(0.01),卵巢体积由术前平均14.2cm3降至9.8cm3,月经情况明显改善,用此方法治疗PCOS患者恢复自然排卵率达92%,5年累计妊娠率达89.8%,无并发症发生。结论:腹腔镜卵巢打孔术治疗PCOS简单易行,患者创伤小,康复快,安全性高,远期疗效好,对子代无不良影响,为药物治疗失败的PCOS患者提供了新的治疗途径。

The clinical study of the long-term effect of laparoscopic ovarian drilling for polycystic ovary syndrome

Objective:To evaluate the long-term effect of laparoscopic ovarian drilling (LOD) for refractory polycystic ovary syndrome (PCOS).Methods:One hundred and thirty-eight women with Clomifene-resistant PCOS were treated by LOD from Jan.2001 to Jun.2007.The changes of serum FSH,LH,E2,T and PRL were observed,and the ovarian volume and shape were compared before and after operation.The ovulation was monitored by examination of basal body temperature and B mode ultrasound after LOD.The menstrual recovery,pregnancy and neonatal information were followed up.Results:The follow up lasted 24-78 months and more than 60 months in 48 cases.After LOD,there was a significant reduction in LH and T (P﹤0.01).The ovarian volume decreased from 14.2cm3 preoperatively to 9.8cm3 postoperatively.The menstrual situation was obviously improved.The natural ovulation rate was 92% and total pregnancy rate during five years was 89.8%.No complications occurred.Conclusions:LOD is simple,mini-invasive,and safe,with quicker recovery,better long-term therapeutic effect and no harmful effects to filial generation.It is an alternative treatment for drug-resistant PCOS patients.