改良小卵泡抽吸对多囊卵巢综合征不育患者的疗效观察

目的探讨B超引导下经阴道改良小卵泡穿刺抽吸术对多囊卵巢综合征（PCOS）不育患者治疗的效果。方法将诊断为PCOS不育患者98例，按照是否进行小卵泡穿刺分为研究组和对照组。比较两组间卵巢过度刺激综合征（OHSS）发生率、妊娠及流产情况及研究组穿刺前后血清激素的变化。结果研究组OHSS发生率为4．09％，无流产发生；对照组OHSS及流产的发生率为16．32％，10．20％，差异有统计学意义（P〈0．01）。研究组术后LH（4．84±0．67）U／L、LH／FSH（0．93±0．26）、T（1．70±0．39）nmol／L及基础卵泡数（30．12±5．96）个均低于术前LH（8．89±1．67）U／L、LH／FsH（1．72±0．48）、T（2．12±0．59）nmol／L及基础卵泡数（35．22±6．52）个水平，差异有显著统计学意义（P〈0．01）；而两组间妊娠率无差异。结论B超引导下经阴道改良小卵泡穿刺抽吸是一种更为安全、有效、经济的治疗方法。能改善PCOS患者内分泌状况，减少卵巢基础窦卵泡数目，减少其后促排卵周期中OHSS发生率，降低流产率。

Clinical observation on treatment of refractory polycystic ovarian syndrome by ultrasound-guided aspiration of small follicles

Objective： To investigate the effect of ultrasound-guided small follicle aspiration on refractory polycystic ovarian syndrome （PCOS） in women with anovulatory infertility. Methods： In this center, 98 infertile patients with PCOS were divided into the research group and the control group according to whether small follicles were punctured. The ovarian hyperstimulation syndrome （OHSS） incidence, pregnancy and abortion rates, and the change of the endocrine profile before and after puncture, the number of the basic follicles and the response to the gonadotropin Were checked and compared between the two groups. Results： Between the research group and the control group, the OHSS incidence （4.09% vs. 16.32%） and spontaneous abortion rate （0% vs. 10.20%） were significantly different （P〈0.01）. There was no difference in pregnancy rate between the two groups. The levels of LH （4.84 ± 0.67 vs. 8.89 ± 1.67 U/L） and T（1. 70±0. 39 vs. 2.12±0.59 nmol/L）, the ratio of LH/FSH （0.93±0.26 vs. 1.72± 0.48）, and the number of basic follicular （30.12±5.96 vs. 35.22±6.52） after puncture were significant lower than before puncture in the research group （P〈0.01）. Conclusion： Ovarian puncture under transvaginal ultrasonic-guided could decrease the basic follicle number of the ovary, improve the endocrine condition, and reduce the incidence of OHSS and spontaneous abortion rate for intractable infertile patients with PCOS. It provides another effective feasible auxiliary treatment approach for infertility.