多囊卵巢综合征；腹腔镜；电凝打孔术；诱导排卵；达英35

腹腔镜卵巢打孔术和药物治疗多囊卵巢综合征内分泌变化及诱导排卵的疗效观察

http://www.100md.com 《腹腔镜外科杂志》 2006年第5期

多囊卵巢综合征；腹腔镜；电凝打孔术；诱导排卵；达英35,,多囊卵巢综合征；腹腔镜；电凝打孔术；诱导排卵；达英35,1资

     【摘要】目的：探讨持续无排卵多囊卵巢综合征(PCOS)患者使用诱发排卵的疗效及其长期预后。方法：收集氯米芬(CC)抵抗的多囊卵巢综合征患者75例。共238个治疗周期，随机分为3组(1)腹腔镜电凝打孔术组；(2)低剂量促卵泡激素(FSH)缓增方案促排卵治疗组；(3)达英35组。观察各组治疗前后FSH、LH、T、E2、PRL、LH/FSH及双侧卵巢体积、卵泡数目及卵泡直径的变化；根据基础体温测定(BBT)及B超监测排卵；并随访受孕情况。结果：随访时间4年，腹腔镜电凝打孔术组妊娠率最高，流产率、卵巢过度刺激综合征(OHSS)和多胎发生的情况极低。3组治疗后血清激素水平均恢复正常，各组间无显著性差异(P>005)。各组治疗后较治疗前有显著性差异(P<005)。3组卵巢体积、直径、卵泡数量治疗后较治疗前有显著性差异(P<005)。结论：三种治疗方法均对难治的多囊卵巢综合征有一定的治疗效果，但腹腔镜电凝打孔术具有治疗周期短、花费少、无卵巢过度刺激综合征和多胎妊娠的发生等优点。

    【关键词】多囊卵巢综合征；腹腔镜；电凝打孔术；诱导排卵；达英35

    Comparative clinical study of the effectiveness of the laparoscopic ovarian electrocoagulation drilling and medications in patients with refractory polycystic ovary syndrome

    PENG Cunxu,TANG Ling,SHI Xiuling.

    Dept. of Obstetrics and Gynecology,Affiliated Hospital of Jining Medical College,Jining 272029,China

    【Abstract】 Objective:To investigate the effectiveness of the methods of induced ovulation by medications or by laparoscopic ovarian electrocoagulation drilling and the longterm outcome.Methods:75 consecutive patients with polycystic ovary syndrome(PCOS)who refractory to CC were enrolled and randomized to 3 groups whose treatment cycles added up to 238:(1)group of laparoscopic ovarian electrocoagulation drilling (Group1);(2)group of FSH with initiallowdose and gradualincrease protocol (Group2);(3)group of Diane35 (Group3).Prior to and after the three different treatments the serum levels of FSH,LH,T,E2,PRL,LH/FSH,ovary volumes,follicle numbers and follicle diameter changes were tested respectively.Meanwhile,the ovulation was monitored by BBT and typeB ultrasound.The pregnancy rates were registered for later analysis.Results:At the end of 4year followup,the pregnancy rates in the Group1 were the highest and rare abortion,OHSS and multiple pregnacy were found.Conclusions:The three defferent treatments were all effective to PCOS patients and the laparoscopic ovarian electrocoagulation drilling has the advantages of shortest treatment duration,lowest costs,rare ocurrences of OHSS and multiple pregnancy. ......

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