腹腔镜治疗难治性多囊卵巢综合征不孕患者38例临床分析  

Clinical Study on the Treatment of Clomiphene-resistant Polycystic Ovarian Syndrome with Laparoscopic Ovarian Drilling

作　　者：沈雷 黄蓉 郭玉霞 刘斌 

机构地区：[1]暨南大学第二附属医院深圳市人民医院,广东深圳518020

出　　处：《实用妇产科杂志》2007年第5期311-313,共3页Journal of Practical Obstetrics and Gynecology

摘　　要：目的：探讨腹腔镜对难治性多囊卵巢综合征（PCOS）不孕的治疗效果。方法：2001年3月至2005年5月对我院诊治的38例难治性PCOS不孕症患者，行腹腔镜下卵巢多点打孔术及盆腔粘连松解、输卵管整形术。手术前后分别测血清黄体生成素（LH）、卵泡刺激素（FSH）、雄激素（T）及雌二醇（E2）水平；术后监测排卵情况、妊娠率及妊娠结果。结果：术后血Lid和T水平较术前有显著性下降（P〈0．01）。术后排卵率81．6％（31／38），1年内累计妊娠18例，妊娠率为47．3％（18／38），早期流产率为16．7％（3／18）。有4例术后3个月内予氯米芬（CC）1。2个疗程后恢复月经外，其余月经情况（经量及持续时间）较术前均有明显改善。结论：腹腔镜卵巢多点打孔术能明显改善难治性PCOS患者的排卵和受孕机会，相对于单纯促排卵药物治疗具有术后排卵率高、妊娠率高、流产率低的优点，尤其对难治性PCOS不孕患者不失为一个有效治疗手段。Objective： To evaluate the efficacy of laparoscopic ovarian drilling in treating clomiphenre - resistant polycystic ovary syndrome （PCOS）.Methods：From 2001.3 to 2004.5, 38 cases diagnosed as PCOS received laparoscopic ovarian drilling. The serum concentrations of LH, FSH, and E2 were respectively compared before and after the operation. Ovarian follicular development, pregnancy rate and abortion rate were observed after operation. Results： There were significant declining of level of LH and T after operations （ P 〈 0. 01 ）. The ovulation rate and pregnancy rates after operation respectively were 81.6% and 47.3%. The early abortion rate was 11.1%. Conclulusions：Laparoscopic ovarian drilling can significantly increase the ovulation rate and pregnancy rate in patient with CC - resistant PCOS.

关 键 词：腹腔镜卵巢打孔术 多囊卵巢综合征 排卵 

分 类 号：R711.750.5[医药卫生—妇产科学]