两种术式治疗多囊卵巢综合征的远期疗效追踪比较

[目的]评价开腹卵巢楔形切除(OWR)和腹腔镜下双侧卵巢电灼开窗术(LOD)两种术式对多囊卵巢综合征(PCOS)的远期疗效.[方法]1981至2001年在我院诊断为PCOS并接受手术治疗的妇女共151例,其中行OWR 61例、LOD 90例,追踪分析两组妇女术后妊娠率、术后妊娠时间的分布及术前后月经模式变化.[结果]两组的临床特征具有可比性,OWR组累积妊娠率84%,LOD组累积妊娠率72%,两组间没有明显差异,绝大部分妊娠发生在术后18个月内;OWR组术后3个月、半年、1年、3年、5年及10年月经规律的妇女所占的比例分别是81.3%、81.3%、77.3%、77.6%、78.9%、85.2%,明显高于术前的31.1%(P值＜0.05);LOD组术后3个月、半年、1年、3年、5年及10年月经规律的妇女所占的比例分别是80.6%、63.5%、56.7%、58.0%、57.6%、42.9%,明显高于术前的35.6%(P值＜0.05);术后OWR组月经规律妇女占的比例明显高于LOD组(P均＜0.05).[结论]两种术式的术后妊娠率相似.OWR比LOD更好、更长远地改善PCOS妇女的月经异常.

Long Term Follow-up of Patients with Polycystic Ovarian Syndrome After Ovarian Wedge Resection or Laparoscopic Ovarian Drilling

Objective To assess the efficacy of OWR and LOD on the women with PCOS Methods The study included 151 PCOS women who underwent OWR(61 women) and LOD(90 wom-en) between 1981 and 2001. The hospital records were reviewed and questionnaires were sent to all the women .Clinical data records included: reproductive history ,menstrual pattern. Results The cumu-lative pregnancy rates were 84% in OWR group ,72% in LOD group .Majority of women became preg-nancy within 18 months after operation . The proportion of women with regular menstrual cycles be-fore OWR or three months ,six months,one year ,five years ,ten years post-OWR were 31.1% ?81.3%?81.3%?77.3%?77.6%?78.9%?85.2% respectively;and the proportion of women with regu-lar menstrual cycles before LOD or three months ,six months,one year ,five years ,ten years post-LOD were 35.6% 80.6%?63.5%?56.7%?58.0%?57.6%?42.9%respectively. Conclusion The cumulative pregnancy rates have no different between two groups ;OWR produces much more long-term improvement in menstrual regularity.