Polycystic ovary syndrome (PCOS) is a major cause of anovulatory infertility. Laparoscopic ovarian drilling (LOD) is a treatment for PCOS that allows the laparoscopic identification of other intra-abdominal lesions an...Polycystic ovary syndrome (PCOS) is a major cause of anovulatory infertility. Laparoscopic ovarian drilling (LOD) is a treatment for PCOS that allows the laparoscopic identification of other intra-abdominal lesions and the provision of diagnostic treatment. This study reports a case of PCOS with an ovarian mass in which LOD was aggressively used and a granulosa cell tumor (GCT) was found. A 34-year-old woman with secondary amenorrhea and irregular menstrual cycles presented to the emergency department with abdominal pain of unknown etiology. Imaging studies revealed a 6-cm left ovarian mass with an internal appearance suggestive of a hemorrhage. The patient’s secondary amenorrhea was subsequently diagnosed as PCOS, and LOD was performed to preserve her fertility. Simultaneously, a cystectomy was performed to evaluate the tumor in the left ovary;the diagnosis was adult-type GCT. Although concomitant GCT and PCOS are extremely rare, the two conditions have similar clinical manifestations. In women of reproductive age, the impact of surgery on future fertility should be considered, and the initial surgical technique should be chosen carefully.展开更多
目的对比二甲双胍与腹腔镜卵巢钻孔治疗克罗米酚和胰岛素抵抗多囊卵巢综合征的疗效。方法110例入院患者随机分为两组,每组55例,一组接受二甲双胍治疗,另一组接受腹腔镜打孔治疗。对治疗前后患者激素代谢参数及口服葡萄糖耐量值进行t检...目的对比二甲双胍与腹腔镜卵巢钻孔治疗克罗米酚和胰岛素抵抗多囊卵巢综合征的疗效。方法110例入院患者随机分为两组,每组55例,一组接受二甲双胍治疗,另一组接受腹腔镜打孔治疗。对治疗前后患者激素代谢参数及口服葡萄糖耐量值进行t检验分析。对患者排卵率、受孕率及流产率进行χ2检验。结果两组患者的总睾酮和胰岛素样生长因子1含量显著下降(P<0.001 vs P<0.001),黄体酮也明显下降(P<0.05 vs P<0.001),而空腹血糖胰岛素比则升高(P<0.001 vs P<0.05)与治疗前相比。接受腹腔镜打孔手术患者的月经正常率、排卵率及受孕率都高于二甲双胍治疗组([76.4%(42/55)vs 58.2%(32/55),P<0.04;50.8%(131/258)vs33.5%(94/281),P<0.001;38.2%(21/55)vs 20.0%(11/55),P<0.03],两组间早期流产率差异无统计学意义。结论尽管二甲双胍能够显著改善患者胰岛素抵抗情况,但是腹腔镜打孔手术能够更为有效地提高肥胖多囊卵巢综合征克罗米芬及胰岛素抵抗患者经期正常率、排卵率及受孕率。展开更多
文摘Polycystic ovary syndrome (PCOS) is a major cause of anovulatory infertility. Laparoscopic ovarian drilling (LOD) is a treatment for PCOS that allows the laparoscopic identification of other intra-abdominal lesions and the provision of diagnostic treatment. This study reports a case of PCOS with an ovarian mass in which LOD was aggressively used and a granulosa cell tumor (GCT) was found. A 34-year-old woman with secondary amenorrhea and irregular menstrual cycles presented to the emergency department with abdominal pain of unknown etiology. Imaging studies revealed a 6-cm left ovarian mass with an internal appearance suggestive of a hemorrhage. The patient’s secondary amenorrhea was subsequently diagnosed as PCOS, and LOD was performed to preserve her fertility. Simultaneously, a cystectomy was performed to evaluate the tumor in the left ovary;the diagnosis was adult-type GCT. Although concomitant GCT and PCOS are extremely rare, the two conditions have similar clinical manifestations. In women of reproductive age, the impact of surgery on future fertility should be considered, and the initial surgical technique should be chosen carefully.
文摘目的对比二甲双胍与腹腔镜卵巢钻孔治疗克罗米酚和胰岛素抵抗多囊卵巢综合征的疗效。方法110例入院患者随机分为两组,每组55例,一组接受二甲双胍治疗,另一组接受腹腔镜打孔治疗。对治疗前后患者激素代谢参数及口服葡萄糖耐量值进行t检验分析。对患者排卵率、受孕率及流产率进行χ2检验。结果两组患者的总睾酮和胰岛素样生长因子1含量显著下降(P<0.001 vs P<0.001),黄体酮也明显下降(P<0.05 vs P<0.001),而空腹血糖胰岛素比则升高(P<0.001 vs P<0.05)与治疗前相比。接受腹腔镜打孔手术患者的月经正常率、排卵率及受孕率都高于二甲双胍治疗组([76.4%(42/55)vs 58.2%(32/55),P<0.04;50.8%(131/258)vs33.5%(94/281),P<0.001;38.2%(21/55)vs 20.0%(11/55),P<0.03],两组间早期流产率差异无统计学意义。结论尽管二甲双胍能够显著改善患者胰岛素抵抗情况,但是腹腔镜打孔手术能够更为有效地提高肥胖多囊卵巢综合征克罗米芬及胰岛素抵抗患者经期正常率、排卵率及受孕率。
