腹腔镜下卵巢打孔术治疗多囊卵巢综合征不孕症48例临床分析

Laparoscopic ovarian drilling in the treatment of infertility of polycystic ovary syndrome:clinical analysis of 48 cases

目的探讨腹腔镜下卵巢电凝打孔术对多囊卵巢综合征不孕症(PCOS)患者的临床疗效。方法选择2006年6月～2008年6月该院诊断PCOS不孕患者48例,行腹腔镜下卵巢电凝打孔术,观察术前、术后血清黄体生成素(LH)、卵泡刺激素(FSH)、睾酮(TOT)、雌二醇(E2)、泌乳素(PRL)水平的变化,术后月经和排卵情况,妊娠率。结果术后LH、TOT、LH/FSH、PRL水平较术前明显降低(P<0.01),而FSH、E2术前、术后差异无显著性(P>0.05),月经情况明显改善,术后排卵率为87.5%,术后2年内妊娠31例,术后累积妊娠率66.22%。结论腹腔镜下卵巢电凝打孔术简单易行,创伤小,术后粘连少,恢复快,为药物诱导排卵失败的PCOS不孕症患者提供了新的治疗途径。

[Objective] To study the clinical effect of laparoscopic ovarian drilling technique of coagulation in treatment of infertility patients with polycystic ovary syndrome.[Methods] Laparoscopic ovarian drilling technique of coagulation was made on 48 patients diagnosed with PCOS infertility in our hospital during June 2006 to June 2008.The serum luteinizing hormone （LH）,follicle stimulating hormone （FSH）,testosterone （TOT）,estradiol （E2）,prolactin （PRL） level changes,post menstruation and ovulation,pregnancy rate were observed before and after surgery.[Results] LH,TOT,LH/FSH,PRL levels were significantly lower than that before operation （P〈0.01）,and FSH,E2 before and after surgery were no significant differences （P〉 0.05）,a marked improvement in menstruation,after surgery the ovulation rate was 87.5 percent.31 cases of pregnancy in 2 years after operation,the cumulative pregnancy rate after operation was 66.22 percent.[Conclusion] The laparoscopic ovarian drilling technique of coagulation is simple,less trauma,less postoperative adhesions and shows rapid recovery for PCOS patients with the failure of drug-induced ovulation.The method might be a new therapeutic approach for PCOS patients with infertility.