超声引导下卵泡穿刺术治疗克罗米芬不敏感多囊卵巢综合征的临床研究  

Ultrasound-guided immature follicle puncture for clomiphene resistent polycystic ovarian syndrome

作　　者：肖育红[1] 周敏[1] 齐倩[1] 

机构地区：[1]沈阳市解放军第202医院,110003

出　　处：《实用医学杂志》2011年第20期3684-3686,共3页The Journal of Practical Medicine

摘　　要：目的:研究超声引导下未成熟卵泡穿刺(IMFP)技术对克罗米芬(CC)不敏感多囊卵巢综合征(PCOS)患者内分泌状态、基础窦卵泡计数、卵巢体积的作用并对治疗前后卵巢过度刺激综合征(OHSS)发生情况和临床妊娠率进行统计学比较。方法:选择2007年9月至2008年9月在我院生殖中心就诊的CC耐药的PCOS患者67例,随机将患者分为观察组32例和对照组35例,对观察组患者应用少量HMG(尿促性腺素)后,在超声引导下反复进行IMFP,穿刺后检查患者的内分泌状态,基础窦卵泡计数及卵巢体积,达到有效标准后行促排卵治疗,观察OHSS发生情况及临床妊娠率。结果:对32例患者进行了78个周期的穿刺治疗,经过1～3次穿刺后,患者睾酮(T)和黄体生成素/卵泡刺激素(LH/FSH)比值转为正常,24例(75%)卵巢体积恢复正常,27例(84.4%)窦卵泡计数降到10个/每侧卵巢以下,之后在行CC或HMG促排卵后可自然同房或人工授精,末次IMFP后随访观察6个月,观察组临床妊娠14例,临床妊娠率43.8%,2例发生中度OHSS,发生率为6.3%,两组临床妊娠率和OHSS发生率差异有显著性。结论:对CC不敏感PCOS患者行IMFP治疗后,患者卵巢体积缩小,窦卵泡数减少,内分泌高雄状态得到改善,OHSS发生率降低及妊娠率提高。Objective To investigate the effect of ultrasound-guided immature follicle puncture technique （IMFP） on the endoerinosity, basic follicles number, and ovarian volumes in patients with elomiphene resistant polyeystic ovarian syndrome （PCOS）, and compare the rates of ovaian hyperstimulation syndrome （OHSS） and pregnancy after the therapy. Methods Sixty-seven patients with elomiphene resistant PCOS from Sep 2008 to Sep 2009 were divided into observe group （n = 32） and control group （n = 35 ）. After applying little amount of HMG to the patients in observe group, IMFP was performed. The changes of the endocrinosity, basic follicles number, and ovarian volumes were observed after IMFP. Patients who reached the effective standard would receive gonadotropin, and then the rates of OHSS and pregnancy were observed. Results After 1-3 times of treatment, the levels of testosterone and LH/FSH ratio became normal in all the patients in observe group. The ovarian volumes were normal in 24 cases （75%）, the basic follicle number decreased to less than 10 per ovary in 27 cases （84.4%）. Patients in observe group were arranged for sexual intercourse or intra-uterine insemination after being administered with CC or HMG. There were 14 patients （43.8%） in observe group acquired pregnancy and 2 patients （6.3%） developed moderate OHSS 6 months after the last IMFP. There were significant differences in the rates of pregnancy and OHSS between the two groups. Conclusion After receiving IMFP, the ovarian volumes and basic follicle number were decreased, the testosterone level was improved, the rate of OHSS was declined, and the rate of pregnancy was raised in patients with clomiphene resistant PCOS.

关 键 词：多囊卵巢综合征 未成熟卵泡 卵泡穿刺术 

分 类 号：R711.75[医药卫生—妇产科学]