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目的:探讨腹腔镜卵巢打孔术(LOD)治疗难治性多囊卵巢综合征不孕症(RIPCOS)的临床效果。方法:68例RIPCOS患者按随机数字表法分为实验组和对照组各34例。对照组予坤泰胶囊、来曲唑片、尿促性腺激素及人绒毛膜促性腺激素等药物治疗;实验组采用LOD治疗,术后卵泡发育仍不成熟,予克罗米芬治疗。两组疗程均为3个月。结果:(1)实验组34例患者手术全部成功,手术时间(32.9±5.1)min,术中出血量(8.8±1.7)ml,住院天数(5.4±1.0)d;(2)治疗后1、3及6个月两组血清黄体生成素、睾酮、雌二醇、体重指数、基础体温、卵巢容积及窦卵泡数均逐渐下降,卵泡直径、成熟卵泡数、月经正常率、排卵率及受孕率均逐渐上升,实验组改善更加明显,与对照组比较差异均有统计学意义(P<0.01或P<0.05)。结论:LOD治疗RIPCOS具有疗效好、损伤小、恢复快、不良反应少等优点,可以明显提高排卵率和受孕率,值得在临床上推广使用。
Objective: To investigate the clinical effect of laparoscopic ovarian drilling (LOD) in refractory polycystic ovary syndrome infertility (RIPCOS). Methods: Sixty-eight patients with RIPCOS were divided into experimental group and control group according to random number table. The control group was treated with Kuntai capsule, letrozole, urinary gonadotropin and human chorionic gonadotropin and other drugs. The experimental group was treated with LOD, and follicular development remained immature after clopidogrel treatment. Two groups of treatment are 3 months. Results: (1) All the 34 patients in the experimental group were operated successfully. The operation time (32.9 ± 5.1) min, intraoperative blood loss (8.8 ± 1.7) ml, and hospitalization days (5.4 ± 1.0) days. (2) Serum luteinizing hormone, testosterone, estradiol, body mass index, basal body temperature, ovarian volume and the number of antral follicles decreased gradually at 3 and 6 months. The follicle diameter, number of mature follicles, normal menstruation, ovulation rate and pregnancy rate (P <0.01 or P <0.05). The difference between the two groups was statistically significant (P <0.01 or P <0.05). Conclusion: LOD treatment of RIPCOS with good efficacy, small damage, rapid recovery, fewer adverse reactions, can significantly improve the ovulation rate and pregnancy rate, it is worth to promote the use of the clinic.