微创手术联合药物治疗多囊卵巢综合征伴不孕对卵巢功能及生育能力的影响  

Influence of minimally invasive surgery combining with drug therapy on ovarian function and fertility of patients with polycystic ovarian syndrome accompanied by infertility

作　　者：张亚琴 蒋维[2] 韩炜[2] 

机构地区：[1]石家庄市妇幼保健院妇三科,石家庄050000 [2]唐山市妇幼保健院妇产科,河北唐山063000

出　　处：《中国性科学》2017年第7期126-129,共4页Chinese Journal of Human Sexuality

基　　金：2016年河北省卫计委医学科学研究重点课题(20160828)

摘　　要：目的:探讨微创手术联合药物治疗多囊卵巢综合征(PCOS)伴不孕对卵巢功能及生育能力的影响。方法:选取2014年1月至2015年1月92例PCOS伴不孕患者纳入研究对象,采用随机数字表法分为对照组和治疗组各46例。对照组单纯服用达英-35治疗,观察组在对照组的基础上联合采用腹腔镜辅助卵巢打孔术(LOD)。比较两组血清激素水平、血流动力学、生育能力等指标。结果:治疗后3个月经周期,观察组血清FSH、PRL、T、LH水平明显低于对照组,E2水平明显高于对照组(P<0.05),PI、PSV、EDV均明显低于对照组(P<0.05);随访1年,观察组排卵率、自然妊娠率、足月分娩率均明显高于对照组(95.65%vs.60.87%,91.30%vs.30.43%,778.57%vs.50.00%)(P<0.05)。结论:腹腔镜微创手术联合达英-35治疗有助于改善多囊卵巢综合征合并不孕患者血清激素水平与血流动力学,进而改善卵巢功能,促进排卵及自然妊娠。Objectives： To investigate the influence of minimally invasive surgery combining with drug therapy on ovarian function and fertility of patients with polycystic ovary syndrome（ PCOS） accompanied by infertility.Methods： 92 patients with PCOS accompanied by infertility admitted to our hospital from January 2014 to January2015 were selected and divided into control group and observation group based on the random number table method,with 46 cases in each group. Patients in the control group were treated with Diane-35,in addition to this therapy,and patients in the observation group were also treated with laparoscopic-assisted ovarian drilling technique（ LOD）. The serum hormone levels,haemodynamics,fertility and other indexes of the two groups were compared.Results： In the third menstrual cycle after treatment,the levels of serum FSH,PRL,T and LH of the observation group were significantly lower than those of the control group,the level of E2 significantly higher than that of the control group（ P〈0. 05）,and the levels of PI,PSV and EDV significantly lower than those of the control group（ P〈0. 05）. In the one year of follow-up visit,the ovulation rate,natural pregnancy rate and term birth rate of the observation group were significantly higher than those of the control group（ 95. 65% vs 60. 87%,91. 30% vs30. 43%,778. 57% vs 50. 00%）（ P〈0. 05）. Conclusion： Laparoscopic minimally invasive procedures combining with Diane-35 is conductive to improving the serum hormone levels and haemodynamics of patients with PCOS accompanied by infertility,and thus improving the ovarian function and promoting ovulation and natural pregnancy.

关 键 词：多囊卵巢综合征 不孕 腹腔镜辅助卵巢打孔术 性激素 卵巢血流 

分 类 号：R711.75[医药卫生—妇产科学]