腹腔镜卵巢打孔对PCOS耐氯米芬患者的疗效研究  

Predictors for Ovulation after Laparoscopic Ovarian Drilling in Polycystic Ovary Syndrome Women with Clomiphene Citrate Resistant

作　　者：曹华斌[1] 向允媛[1] 吴荣珍[1] 

机构地区：[1]江西省妇幼保健院,江西南昌330006

出　　处：《实用妇产科杂志》2007年第3期157-160,共4页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:观察腹腔镜手术治疗耐氯米芬(CC)多囊卵巢综合征(PCOS)不孕患者疗效的影响因素。方法:对46例耐氯米芬的PCOS患者行腹腔镜卵巢打孔术,按术后6周内是否恢复排卵分有效组(排卵)和无效组(无排卵)。分析两组间患者的年龄、不孕年限、体重指数(BMI)、性激素水平对临床疗效的影响。结果:术后有38例患者发生排卵,26例成功妊娠;8例即使在加用CC后仍无排卵与妊娠。有效组术前患者血清LH、LH/FSH的水平明显比无效组高,而不孕年限、BMI明显比无效组低;术后血清LH、LH/FSH及T水平明显下降,FSH及PRL水平无明显变化。无效组手术前后患者血清LH、LH/FSH水平无明显变化,术后血清FSH及PRL水平有上升的趋势。结论:对耐氯米芬PCOS患者行腹腔镜治疗时,术前患者不孕年限、BMI、LH、LH/FSH水平及术后LH、LH/FSH及T水平的下降幅度是预测术后排卵有效的指标,同时应该全面考虑患者的FSH、PRL水平的变化。Objective： To analyze preoperative and postoperative factors affecting the efficacy of laparoscopic ovarian drilling （LOD） for inducing ovulation in clomiphene citrate （CC）-resistant PCOS patients.Methods：46 infertile women with CC-resistant PCOS received LOD.The influence of the various preoperative and postoperative charactedstics on the ovulation rates after LOD was evaluated. The ovulation rates were compared between the categories of each factor, Results： After LOD, ovulation occurred in 38 patients; pregnancy occurred in 26 patients; and anovulation occurred in 8 patients after LOD, even followed by CC treatment. Preoperative serum luteinizing hormone （LH） levels and the LH/follicle-stimulating hormone （FSH） ratio were significantly higher in the ovulating group than in the non-ovulating group. PCOS women with elevated body mass index （BMI） and longer infertile duration seemed to poorly respond to LOD. Postoperative serum LH and T levels and the LH/FSH ratio significantly dropped in ovulating group,but unchanged in the non-ovulating group which conversely with increasing tendency of serum FSH and Prolactin levels.Conclusions： Preoperative serum LH levels, BMI and duration of infertility may be good predictors of LOD efficacy in patients with PCOS,while as the extent of decrease serum LH levels,the LH/FSH ratio and T levels after LOD.

关 键 词：多囊卵巢综合征 腹腔镜 排卵 

分 类 号：R711.75[医药卫生—妇产科学]