不同方法治疗多囊卵巢综合征的疗效观察

目的:探讨药物和手术治疗多囊卵巢综合征(PCOS)的疗效。方法:选择2000～2005年诊断为PCOS的581例患者作为研究对象,随机分为药物治疗组(317例)和手术治疗组(264例)。药物组用口服避孕药(OC)治疗3个周期后行促排卵治疗;手术组采用经腹卵巢楔形切除术(OWR)和腹腔镜下卵巢电凝打孔术(LOD)。其中96例行卵巢楔形切除术,168例行腹腔镜下卵巢电凝打孔术。观察患者的血清基础激素水平(LH/FSH、E2、T)、自然排卵率,追踪2年妊娠结果。结果:手术组(OWR和LOD)在术后激素水平和排卵率发生显著变化(P<0.05),两种手术方式无显著差异(P>0.05),但LOD组的妊娠率高于OWR组(P<0.05);与药物组相比较,LOD组在恢复排卵的月经周期数和妊娠率方面有显著差异(P<0.05)。结论:LOD较OWR具有损伤小、术后粘连少等优点,可提高PCOS患者术后的排卵率及妊娠率。部分难治的不孕症患者对药物促排卵无反应,或虽有排卵但未妊娠者可考虑手术治疗。

The curative effect of polycystic ovary syndrome related infertility by different means

Objective:To discuss the curative effect of polycystic ovary syndrome(PCOS)by medicament and operation.Methods:581 cases diagnosed as PCOS were selected as study object,then selected randomly 317 cases treated by medicament and the other 264 cases treated by operation.Medicament group were cured three cycles by oral prophylactic(OC)and then accepted pro-ovulation;operation group were cured by ovarian wedge resection(OWR)or laparoscopic ovarian drilling(LOD).In operation group,96 cases were used OWR and 168 cases were used LOD.All patients were observed the level of basic hormone in serum(including LH,FSH,LH/FSH,E2,T),the rate of nature ovulation,and traced the result of gestation after two years.Results:Operation group(including OWR and LOD)had occurred distinct change after operation(P<0.05),but it was not different between OWR and LOD(P>0.05).Compared the rate of gestation between two groups,the LOD group was distinctly higher than OWR group(P<0.05).Compared LOD group with medicament group,there were distinct differences of the cycle of coming back ovulation and gestation rate(P<0.05).Conclusion:LOD has the strongpoints of little damage and conglutination compared with OWR.And LOD could raise the rates of ovulation and gestation.Some patients of clomiphene-resistant who could not produce ovulation by pro-ovulation medicine or could produce ovulation but not gestate could be advised treatment by LOD.