腹腔镜卵巢打孔术治疗耐克罗米酚多囊卵巢综合征

目的探讨腹腔镜卵巢打孔术治疗耐克罗米分多囊卵巢综合征（PCOS）合并不孕的临床价值、适应证及机理。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,观测术后排卵、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;而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克罗米芬（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排卵药物以提高妊娠率。

Therapeutic Effect of Laparoscopic Ovarian Drilling on Patients of Polycystic Ovary Syndrome with Clomiphene-resistance

Objective To evaluate the clinical applying value,inclication andmechanism of laparoscopic ovarian dilling for treatment of polycystic ovarian syndrome(PCOS)in clomiphene-resistant anovulatroy women.Methods 37 patients were clomiphene-resistant anovulatory with PCOS.Laparoscopic ovarian drilling use an insulated needle cautery.They were observed the changes of blood FSH,LH,LH/FSH,T,PRL,E2 and the ovuatory rate,pregnancy rate,abortion rate.Results The ovalation rat ewas 89.19%,the pregnancy rate was 54.05%,the abortion rate was 10.00%,the level of blood LH,LH/FSH,T and PRL decreased apparently and FSH,E2 decreased gently.Conclusion Laparoscopic ovarian drilling is an effective alternative treament in clomiphene-resistant anovulatroy women with PCOS.The use ofan insulated needle cautery is rapid effective,simple,safe,minimal invation and less adhesion.The opportunity and indication of operation should be controlled.