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目的探讨腹腔镜下卵巢打孔术联合克罗米芬对难治性多囊卵巢综合征(Polycystic Ovary Syndrome,PCOS)不孕的治疗效果。方法选择2014年1月-2015年12月奉化市中医医院妇产科行腹腔镜下卵巢打孔术、术后给予克罗米芬促排卵治疗难治性PCOS不孕患者76例作为研究对象,检测手术前后激素水平变化情况,阴道超声检查手术前后卵巢大小、卵巢数目和大小以及术后排卵及妊娠情况。结果 76例难治性PCOS不孕患者术后1个月和术后3个月睾酮及黄体生成素(LH)水平均明显低于治疗前(P<0.05),术后3个月LH水平低于术后1个月水平(P<0.05),术后3个月和术后1个月睾酮水平比较,差异无统计学意义(P>0.05);术后1个月、术后3个月和术前E2及卵泡刺激素(FSH)比较,差异均无统计学意义(P>0.05);术后1个月和术后3个月卵巢体积和卵泡数目均低于术前(P<0.05),术后3个月卵巢体积和卵泡数目和术后1个月比较,差异无统计学意义(P>0.05)。克罗米芬促排卵治疗3个月内共有218个月经周期监测排卵,有189个月经周期排卵,3个月内累计排卵率为86.7%;术后共有39例妊娠,妊娠率为51.3%,流产率为7.7%。结论腹腔镜下卵巢打孔术联合克罗米芬治疗难治性PCOS不孕的效果显著,排卵率和妊娠率高。
Objective To investigate the effect of laparoscopic ovarian drilling combined with clomiphene on the treatment of refractory polycystic ovarian syndrome (PCOS) infertility. Methods From January 2014 to December 2015, 76 cases of refractory PCOS infertility were treated with laparoscopic ovariectomy in Department of Obstetrics and Gynecology of Fenghua Hospital of Traditional Chinese Medicine and clomiphene for ovulation induction. The patients underwent surgery Before and after changes in hormone levels, vaginal ultrasound before and after ovarian size, ovarian number and size and postoperative ovulation and pregnancy. Results The levels of testosterone and luteinizing hormone (LH) in 76 patients with refractory PCOS infertility at 1 month and 3 months after operation were significantly lower than those before treatment (P <0.05), and the levels of LH at 3 months after operation There were no significant differences in testosterone levels at 1 month postoperatively (P <0.05), 3 months postoperatively and 1 month postoperatively (P> 0.05); 1 month postoperatively, 3 months postoperatively (P> 0.05). The ovarian volume and number of follicles at 1 month and 3 months after operation were significantly lower than those before operation (P <0.05), and there was no significant difference between preoperative E2 and follicle stimulating hormone (FSH) ). There was no significant difference in ovarian volume and number of follicles at 3 months after operation and 1 month after operation (P> 0.05). Clomiphene ovulation therapy within a total of 218 months menstrual cycle monitoring ovulation, 189 menstrual cycles ovulation, cumulative ovulation rate was 86.7% within 3 months; a total of 39 pregnancies after pregnancy, the pregnancy rate was 51.3%, abortion rate 7.7%. Conclusion laparoscopic ovarian drilling combined with clomiphene in the treatment of refractory PCOS infertility significant effect of ovulation and pregnancy rate.