腹腔镜卵巢打孔术治疗耐克罗米芬多囊卵巢综合征

目的探讨腹腔镜卵巢打孔术治疗耐克罗米芬（CC）多囊卵巢综合征（PCOS）合并不孕的临床价值、适应证及机制。方法对符合PCOS标准的不孕症37例采用腹腔镜电针双侧卵巢打孔术，观察术后排卵、妊娠、流产情况，比较手术前后血FSH，LH，LH／FSH，T，PRL，E2值的变化及月经情况的改变。结果术后血清LH、LH／FSH、T及PRL水平较术前明显下降；血液FSH和E2术后较术前轻度降低。术后排卵率为89．19％。妊娠率为54．05％，早期流产率为10．00％，无一例发生卵巢过度刺激综合征（OHSS）。结论腹腔镜卵巢打孔术可提高PCOS合并不孕患者的自然排卵率及对CC的敏感性，从而提高妊娠率，是PCOS不孕症特别是难治性PCOS患者恢复卵巢生理功能的有效手段，但应掌握手术时机和手术指征。术后3个月未妊娠者尽早采用促帕卵药物，以提高妊娠率。

Therapeutic Effect of Laparoscopic Ovarian Drilling in the Treatment of Polycystic Ovary Syndrome with Clomiphene

[ Objective] To evaluate the clinical application value, application symptoms and mechanism of laparoscopic ovarian drilling in the treatment of polycystic ovary syndrome （PCOS） combined with infertility. [ Methods] Laparoscopic ovarian drilling was carried out on 37 infertile patients who accorded with the PCOS criteria; observation was made on the situation of ovulation, pregnancy and abortion; comparison was made on the changes of blood FSH, LH, LH/FSH, T, PRL, E2 and menstruation before and after the operation. [Results] The level of LH, LH/FSH, T and PRL decreased significantly after the operation; blood FSH and E2 decreased slightly; the ovulation rate, pregnant rate and the early abortion rate after the operation were 89.19%, 54.05% and 10.00% respectively; no PCOS was found. [ Conclusion] Laparoscopic ovarian drilling can improve the natural ovulation rate and sensitivity towards CC of the patients with PCOS combined with infertility, therefore can improve the patients＇pregnant rate; it is an effective method for improving the ovary function of the patients of PCOS infertility, especially refractory PCOS; FSH should be used 3 months after the operation in order to improve the pregnant rate.