腹腔镜胃袖状切除对多囊卵巢综合征生殖内分泌功能改善的作用

目的：探讨腹腔镜胃袖状切除术改善多囊卵巢综合征（ polycystic ovary syndrome，PCOS）生殖内分泌失调的可行性及临床疗效。方法2012年2月～2014年2月，对11例伴有肥胖的PCOS患者行腹腔镜胃袖状切除术，观察月经周期、生殖内分泌及体重等的变化。结果11例均成功完成腹腔镜胃袖状切除术，10例（10／11）术后3个月内月经恢复正常周期，其中6例（6／6）术前稀发排卵的患者均恢复正常排卵，4例术前高雄激素血症患者术后3个月雄激素水平均恢复到正常范围，4例（4／7）多毛患者术后3～6个月Ferriman-Gallwey多毛评分降至5分以下。术后随访3～24个月，BMI下降4．1～7．6，（5．3±1．5）。结论腹腔镜胃袖状切除术能有效改善肥胖的PCOS患者的临床症状，术后短时间内月经恢复，不排卵、高雄激素血症改善。

Effects of Laparoscopic Sleeve Gastrectomy on Reproductive Endocrine Functions in Patients with Polycystic Ovary Syndrome

Objective To explore the feasibility and clinical efficacy of laparoscopic sleeve gastrectomy for the improvement of reproductive endocrine functions in patients with polycystic ovary syndrome. Methods From February 2012 to February 2014, a total of 11 patients with polycystic ovarian syndrome underwent laparoscopic sleeve gastrectomy.The therapeutic effects of the operation like weight loss, menstrual cycle, and reproductive endocrine functions were followed up and observed. Results The laparoscopic sleeve gastrectomy was performed successfully in all the 11 patients.During postoperative follow-up, 10 （10/11） patients obtained normal menstruation in 3 months, and 6 （6/6） patients recovered from oligomenorrhea symptoms.At 3 months after surgery, 4 patients with hyperandrogenism preoperatively recovered to the normal levels.Four （ 4/7 ） patients with hirsute-syndrome were improved obviously after 3-6 months, with the Ferriman-Gallwey scores lower than 5.The BMI was decreased by 4.1-7.6 （5.3 ±1.5） during follow-up for 3 -24 months. Conclusion Laparoscopic sleeve gastrectomy can effectively improve clinical symptoms of obese patients with polycystic ovary syndrome, with fast recovery of menstrual cycle in a short time and significantly relieved hyperandrogenism.