贵州医科大学学报

2020, v.45;No.235(04) 482-485+490

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腹腔镜下卵巢打孔数目对枸橼酸氯米芬抵抗多囊卵巢综合征疗效的影响
The Effect of the Holes Perforated in Ovaries by Laparoscopy on the Efficacy of Clomiphene Citrate against Polycystic Ovary Syndrome

王厚梅;陈琨;翁宇红;李星宇;
WANG Houmei;CHEN Kun;WENG Yuhong;LI Xingyu;Department of Obstetrics and Gynecology,the Affiliated Hospital of Guizhou Medical University;

摘要(Abstract):

目的:探讨腹腔镜下卵巢打孔数目对枸橼酸氯米芬抵抗多囊卵巢综合征患者疗效的影响。方法:64例枸橼酸氯米芬抵抗多囊卵巢综合征合并不孕症患者平均分为实验组和对照组,每组32例;实验组单侧卵巢打孔30~40个,双侧总计60~80个;对照组单侧卵巢打孔4~10个,双侧总计8~20个;观察两组患者手术前后血清卵泡雌激素(FSH)、黄体生成素(LH)、雌二醇(E2)及睾酮(T)值变化,比较打孔术后自发排卵率和妊娠自然娠率。结果:实验组和对照组打孔术后较术前血清LH和T值均显著下降,差异有统计学意义(P <0. 01),FSH和E2均无明显变化,差异无统计学意义(P> 0. 05);实验组术后血清FSH、LH、E2和T值较对照组无明显变化,差异无统计学意义(P> 0. 05);实验组打孔术后自发排卵率显著高于对照组,差异有统计学意义(P <0. 01);两组打孔术后自然妊娠率比较,差异无统计学意义(P> 0. 05)。结论:腹腔镜下增加卵巢打孔数目治疗枸橼酸氯米芬抵抗多囊卵巢综合征患者是安全有效的,打孔数增多可以提高自发排卵率,但不增加自然妊娠率。
Objective: To investigate the effect of laparoscopic ovarian punching on the efficacy of clomiphene citrate in patients with polycystic ovary syndrome. Methods: 64 patients with clomiphene citrate resistant polycystic ovary syndrome combined with infertility were divided into experimental group and control group,32 cases in each group; there were 30 ~ 40 holes in unilateral ovary and 60 ~80 holes in bilateral ovaries in the experimental group while there were 4 ~ 10 holes in unilateral ovary and 8 ~ 20 holes in bilateral ovaries. The changes of serum follicle estrogen( FSH),luteinizing hormone( LH),estradiol( E2) and testosterone( T) values before and after operation were observed and the spontaneous ovulation rate and natural pregnancy rate of two groups of patients after perforation were compared. Results: The serum LH and T values of the experimental group and the control group after perforation were significantly lower than before surgery,the difference was statistically significant( P <0. 01),and there was no significant change in FSH and E2,the difference was not statistically significant( P > 0. 05); The postoperative serum FSH,LH,E2 and T values of the experimental group were not significantly changed compared with the control group,and the difference was not statistically significant( P > 0. 05); the spontaneous ovulation rate of the experimental group after perforation was significantly higher than that of the control group,the difference was statistically significant( P < 0. 01); there was no statistically significant difference between the two groups in the natural pregnancy rate after perforation( P > 0. 05). Conclusion: Increasing the number of ovarian punches under laparoscopy is safe and effective in the treatment of clomiphene citrate in patients with polycystic ovary syndrome. More punches can increase the spontaneous ovulation rate,but not increase the natural pregnancy rate.

关键词(KeyWords): 腹腔镜;多囊卵巢综合征;卵巢打孔数;枸橼酸氯米芬抵抗
laparoscopes;polycystic ovary syndrome(PCOS);number of ovarian perforations;clomiphene citrate resistance

Abstract:

Keywords:

基金项目(Foundation): 贵阳市科技计划项目[筑科合同(20161001)49号]

作者(Author): 王厚梅;陈琨;翁宇红;李星宇;
WANG Houmei;CHEN Kun;WENG Yuhong;LI Xingyu;Department of Obstetrics and Gynecology,the Affiliated Hospital of Guizhou Medical University;

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DOI: 10.19367/j.cnki.1000-2707.2020.04.020

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