腹腔镜下卵巢打孔术联合枸橼酸克罗米芬治疗难治性多囊卵巢综合征的临床观察

目的:探究腹腔镜下卵巢打孔术联合枸橼酸克罗米芬治疗难治性多囊卵巢综合征的临床疗效。方法:选取我院2012年9月至2014年9月收治的难治性多囊卵巢综合症患者共122例,按照治疗方式不同分为对照组(n=61)与观察组(n=61),对照组患者接受单纯枸橼酸克罗米芬治疗,观察组患者接受腹腔镜下卵巢打孔术联合术后枸橼酸克罗米芬治疗。比较两组患者性激素五项变化,卵巢体积、卵泡数量变化及排卵率与自然妊娠率。结果:两组患者治疗前性激素五项水平无明显差异(P0.05)。治疗后,观察组LH、雄激素明显低于对照组(P0.05)。治疗后,对照组FSH、LH均高于治疗前(P0.05),观察组LH、雄激素低于治疗前(P0.05)。两组患者治疗前平均卵巢体积与平均卵泡数量无统计学差异(P0.05)。治疗后,观察组平均卵泡数量明显多于对照组(P0.05)。观察组治疗后平均卵泡数量多于治疗前(P0.05)。观察组排卵率与自然妊娠率分别为87.4%与45.9%,均明显高于对照组(P0.05)。结论:腹腔镜下卵巢打孔术联合枸橼酸克罗米芬能够有效降低血清LH与雄激素,提高卵巢储备功能,增加患者排卵率与自然妊娠率,值得临床推广应用。

Laparoscopic ovarian drilling combined with clomiphene citrate in the treatment of refractory polycystic ovary syndrome

Objectives:To explore the clinical efficacy of laparoscopic ovarian drilling combined with clomiphene citrate for the treatment of refractory polycystic ovary syndrome.Methods:A total of 122 patients with refractory polycystic ovary syndrome were selected in our hospital from September 2012 to September 2014,and divided into the control group (N =61) and the observation group (N =61) according to the different treatment methods.The control group received simple clomiphene citrate treatment,while the observation group received laparoscopic ovarian drilling combined with clomiphene citrate treatment.The changes in five sex hormones before and after treatment,the changes in ovarian volume and the number of ovarian follicles and ovulation,ovulation rate and natural pregnancy rate were compared between two groups.Results:There were no significant differences between the two groups before treatment in five sex hormones,P ＞ 0.05.After treatment,the LH and androgen in the observation group was significantly lower than that of the control group,P ＜ 0.05.After treatment,the FSH and LH of the control group were higher than those before treatment,P ＜ 0.05,while LH and androgen in the observation group was lower than before treatment,P ＜ 0.05.There was no significant difference in the average ovary volume and the average number of follicles between the two groups before treatment,P ＞ 0.05.After treatment,the average number of follicles in the observation group was significantly higher than that in the control group,P ＜ 0.05.After treatment,the average number of follicles in the observation group was more than thai before treatment,P ＜ 0.05.The ovulation rate and natural pregnancy rate in the observation group were 87.4％ and 45.9％ respectively,which were significantly higher than those in the control group,P ＜ 0.05.Conclusion:Laparoscopic ovarian drilling combined with clomiphene citrate can effectively reduce serum luteinizing hormone and androgen,improve ovarian reserve function and increase ovulation rate and natural pregnancy rate,which is worthy of clinical application.