诱导排卵联合卵泡穿刺术对多囊卵巢综合征性排卵障碍患者的治疗效果

The effect of induced ovulation combined with follicular puncture on patients with ovulatory dysfunction of polycystic ovary syndrome

目的探讨诱导排卵联合卵泡穿刺术对多囊卵巢综合征性排卵障碍患者的治疗效果。方法以门诊号为编号,根据随机数字表,将140例多囊卵巢综合征性排卵障碍患者随机分成2组,每组70例。对照组给予诱导排卵治疗,于患者月经期第5天开始,口服环丙孕酮,3周期后,于月经第5天,口服克罗米芬,阴式B超下监测,待出现直径为16 mm左右卵泡时,肌注5 000 U人绒毛膜促性腺激素(HCG),近卵泡发育成熟时次日告知患者同房;观察组则于近卵泡发育成熟时行卵泡穿刺术,并告知患者次日同房。比较临床妊娠率及安全性。结果观察组患者治疗周期总数为147周,优势卵泡出现率为97.3%(143/147),对照组患者治疗周期总数为202周,优势卵泡出现率为97.0%(196/202),组间比较P>0.05;观察组排卵率达100%,妊娠率为34.2%,均高于对照组的68.4%和10.0%,P<0.05;观察组轻度卵泡过度刺激综合征(OHSS)69例,占98.6%,高于对照组的87.1%,OHSS发生情况组间比较差异有统计学意义(P<0.05),2组多胎发生几率比较差异无统计学意义(P>0.05)。结论诱导排卵联合卵泡穿刺术可有效提高多囊卵巢综合征患者的优势卵泡出现率,提高临床妊娠率,具有一定的临床价值。

Objective To investigate the effect of ovulation induction combined with follicular puncture on patients with ovulatory dysfunction of polycystic ovary syndrome. Methods According to the random number table,140 patients with polycystic ovary syndrome were randomly divided into two groups（ n = 70）. The patients of control group were given ovulation induction treatment. On the Fifth days of menstruation,with oral cyproterone and after 3 cycles,on the fifth day of the menstrual cycle,with oral clomiphene as well as vaginal ultrasound monitoring,and when the emergence of follicle diameter was about 16 mm,intramuscular HCG,5 000 U,inform patients of intercourse on the next day when the follicle was nearly mature; The patients in control group were given follicular puncture when the follicle was nearly mature and were informed of intercourse on the next day. Compare clinical pregnancy rate and safety. Results The total treatment period in the observation group was 147 cycles,the dominant follicle was 97. 3%（ 143/147）,patients in the control group treatment period of 202 cycles,the dominant follicle was 97%（ 196/202）,P〉0. 05; The ovulation rate in observation group was 100%,the pregnancy rate was 34. 2%,higher than that of the control group 68. 4% and 10%,P〈0. 05; In observation group,69 cases of mild OHSS,accounting for 98. 6%,higher than that of the control group 87. 1%,and the incidence of OHSS had statistically significant difference between groups（ P〈0. 05）,There was no statistical difference of OHSS occurrence between groups,P〉0. 05. Conclusion Induction ovulation combined with follicular puncture can effectively improve the incidence of dominant follicles in patients with polycystic ovary syndrome,improve the clinical pregnancy rate,and has a certain clinical value.