超声引导卵泡穿刺电凝打孔治疗多囊卵巢综合征的临床应用

Ultrasound guided immature follicle puncture and unipolar electrocoagulation technique via vagina in treating polycystic ovarian syndrome

目的探讨介入超声下穿刺电凝未成熟卵泡对改善无排卵多囊卵巢(PCOS)患者内分泌状态的价值。方法对39例PCOS不孕症患者进行经阴道实时超声引导下未成熟卵泡穿刺抽吸卵泡液,同时电凝打孔,观察术前、术后黄体生成素(LH)、卵泡刺激素(FSH)、睾酮(T)、泌乳素(PRL)、雌激素(E1)水平,术后排卵及妊娠情况等。结果39例患者中,36例术后月经情况明显改善,术后外周血清LH、LH/FSH、T、PRL及E1水平较术前降低,而FSH明显升高,术前术后具有显著性差异。术后妊娠率69%(27/39)。结论超声引导下穿刺电凝未成熟卵泡,可以显著改善PCOS患者体内激素紊乱状态,提高妊娠率,并发症少,是药物治疗无效的PCOS患者安全有效的治疗方法。

Objective To investigate the value of ultrasound guided immature follicle puncture and unipolar electrocoagulation technique in improving endocrine situation in the women with polycystic ovarian syndrome （PCOS）. Methods Thirty- nine patients with PCOS were treated by ultrasound guided immature follicle puncture and unipolar electrocoagulation technique. The changes of LH, FSH, T, PRL and E1 were observed before and after operation. Ovulatory rate and pregnancy rate were recorded. Results Thirty-six of 39 patients had significant improvement in menstrual flow. Significant decrease in LH, LH/FSH, T, PRL and significant increase in FSH were shown after operation （P〈0.01）, the pregnancy rate was 690,% （27/39）. Conclusion Ultrasound guided immature follicle puncture and unipolar electrocoagulation technique can significantly improve the endocrine situation and pregnancy rate, with few complications. It is an effective treatment in clomiphene-resistant anovulatory women with PCOS.