难治性多囊卵巢综合征患者采用腹腔镜下卵巢打孔术治疗临床应用价值探讨
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摘要
目的:研究与探讨腹腔镜下卵巢打孔术治疗难治性多囊卵巢综合征患者的临床应用价值。方法:选取2010年4月至2015年5月在我院进行手术治疗的难治性多囊卵巢综合征患者320例,根据患者采用不同的手术方式分为对照组和观察组各160例,对照组采用B超作用下经阴道卵泡穿刺术治疗,观察组采用腹腔镜下卵巢打孔术治疗。比较两组患者手术后激素水平、排卵情况以及妊娠率,同时针对观察组激素水平进行术前和术后数据统计。结果:观察组术后与术前激素水平比较,差异具有统计学意义(P<0.05);两组术后比较,观察组血清FSH升高,LH、T、LH/FSH明显降低,且差异具有统计学意义(P<0.05);观察组的自然排卵率和妊娠率明显提高,流产率明显下降,差异具有统计学意义(P<0.05)。结论:采用腹腔镜下卵巢打孔术治疗难治性多囊卵巢综合征具有显著的疗效,值得临床方面广泛推广。
Objectives: To investigate clinical value of laparoscopic ovarian drilling in the treatment of refractory polycystic ovary syndrome( PCOS). Methods: 320 patients with refractory PCOS from April 6,2010 to May 9,2015 were selected. According to surgical methods,they were divided into control group and observation group,with 160 cases in each group. Control group received B ultrasonic transvaginal follicular puncture,and observation group received laparoscopic ovarian drilling treatment. Hormone levels,ovulation and pregnancy rates of two groups after surgery were compared. Preoperative and postoperative hormone levels in observation group were statistically analyzed. Results: The difference between preoperative and postoperative hormone levels in observation group was statistically significant( P < 0. 05). After treatment,serum FSH increased and LH,T and LH/FSH significantly decreased in both groups,more significant in the observation group with statistically significant differences( P < 0. 05). The natural ovulation and pregnancy rates of observation group significantly increased,and abortion rates significantly decreased,with statistically significant differences( P < 0. 05). Conclusion: Laparoscopic ovarian drilling treatment on refractory PCOS has significant effect,which is worthy of widely application.
Objectives: To investigate clinical value of laparoscopic ovarian drilling in the treatment of refractory polycystic ovary syndrome( PCOS). Methods: 320 patients with refractory PCOS from April 6,2010 to May 9,2015 were selected. According to surgical methods,they were divided into control group and observation group,with 160 cases in each group. Control group received B ultrasonic transvaginal follicular puncture,and observation group received laparoscopic ovarian drilling treatment. Hormone levels,ovulation and pregnancy rates of two groups after surgery were compared. Preoperative and postoperative hormone levels in observation group were statistically analyzed. Results: The difference between preoperative and postoperative hormone levels in observation group was statistically significant( P < 0. 05). After treatment,serum FSH increased and LH,T and LH/FSH significantly decreased in both groups,more significant in the observation group with statistically significant differences( P < 0. 05). The natural ovulation and pregnancy rates of observation group significantly increased,and abortion rates significantly decreased,with statistically significant differences( P < 0. 05). Conclusion: Laparoscopic ovarian drilling treatment on refractory PCOS has significant effect,which is worthy of widely application.
引文
[1]莫有敏,杨菁.二甲双胍联合克罗米芬治疗多囊卵巢综合征有效性的Meta分析.武汉大学学报(医学版),2013,34(1):99-104.
[2]魏鏡讚,王秀霞.多囊卵巢综合征与DNA甲基化相关性研究进展.中国实用妇科与产科杂志,2013,29(1):71-73.
[3]Movahed Z,Kohan L,Fallahi S,et al.Influence of chemerin rs17173608 polymorphism on polycystic ovary syndrome susceptibility.Taiwan J Obstet Gynecol,2015,54(3):280-283.
[4]Kohan L,Zarei A,Fallahi S,et al.Association between vaspin rs2236242 gene polymorphism and polycystic ovary syndrome risk.Gene,2014,539(2):209-212.
[5]林芸.多囊卵巢综合征的远期并发症.广东医学,2013,34(1):6-8.
[6]饶龙泉.腹腔镜卵巢打孔术对多囊卵巢综合征患者抗苗勒激素水平的影响.中国内镜杂志,2013,19(6):589-592.
[7]于晨芳,李秀琴,闫爱新.腹腔镜卵巢打孔术联合中药治疗难治性多囊卵巢综合征不孕患者的临床观察.中国中西医结合杂志,2013,33(10):1422-1424.
[8]胡波,张纪源,杨小春.二甲双胍联合克罗米芬治疗多囊卵巢综合征合并不孕的疗效分析.中国妇幼保健,2012,27(16):2487-2489.
[9]陈彩蓉,王秋香,邱佩嫦,等.多囊卵巢综合征合并不孕与子宫内膜病变关系的临床探讨.中国妇幼保健,2012,27(21):3291-3293.
[10]Minagawa K,Watanabe T,Oyanagi R.Characteristics of women with epilepsy who developed polycystic ovary syndrome owing to the therapy with valproate sodium.No To Hattatsu,2013,45(4):304-308.
[11]李昱川.多囊卵巢综合征患者脂代谢紊乱与体重、胰岛素抵抗和雄激素水平的关系.中国妇幼保健,2014,29(3):354-356.
[12]张庆芳.腹腔镜卵巢打孔联合药物治疗难治性多囊卵巢综合征临床分析.中国内镜杂志,2014,20(4):411-413.
[13]郭政,王丽英,李华.腹腔镜卵巢打孔术联合中药治疗多囊卵巢综合征不孕的疗效分析.中国妇幼保健,2015,30(12):1931-1932.
[14]谢秀敏,朱卫华,江容.腹腔镜下卵巢打孔术治疗多囊卵巢综合征合并不孕症的有效性及安全性.广东医学,2013,34(15):2373-2375.
[15]蒋建发,孙爱军.多囊卵巢综合征手术治疗的利与弊.中国实用妇科与产科杂志,2013,29(11):856-860.
[16]冯月枝,张清学.PCOS患者卵巢打孔对卵巢储备功能的影响.实用妇产科杂志,2012,28(6):425-426.
[17]张婷,许彦来.补肾活血清肝方联合氯米芬治疗多囊卵巢综合征90例临床观察.中国中医基础医学杂志,2014,20(2):266-267,282.
[18]冯月枝,李琳,李予,等.腹腔镜卵巢打孔对多囊卵巢综合征患者体外受精结局的影响.广东医学,2013,34(1):18-21.
[19]李建青,丁鸿燕,徐雪泉,等.多囊卵巢综合征患者血清胰岛素、性激素的水平及其临床意义.中国卫生检验杂志,2013,23(5):1236-1237,1338.
[2]魏鏡讚,王秀霞.多囊卵巢综合征与DNA甲基化相关性研究进展.中国实用妇科与产科杂志,2013,29(1):71-73.
[3]Movahed Z,Kohan L,Fallahi S,et al.Influence of chemerin rs17173608 polymorphism on polycystic ovary syndrome susceptibility.Taiwan J Obstet Gynecol,2015,54(3):280-283.
[4]Kohan L,Zarei A,Fallahi S,et al.Association between vaspin rs2236242 gene polymorphism and polycystic ovary syndrome risk.Gene,2014,539(2):209-212.
[5]林芸.多囊卵巢综合征的远期并发症.广东医学,2013,34(1):6-8.
[6]饶龙泉.腹腔镜卵巢打孔术对多囊卵巢综合征患者抗苗勒激素水平的影响.中国内镜杂志,2013,19(6):589-592.
[7]于晨芳,李秀琴,闫爱新.腹腔镜卵巢打孔术联合中药治疗难治性多囊卵巢综合征不孕患者的临床观察.中国中西医结合杂志,2013,33(10):1422-1424.
[8]胡波,张纪源,杨小春.二甲双胍联合克罗米芬治疗多囊卵巢综合征合并不孕的疗效分析.中国妇幼保健,2012,27(16):2487-2489.
[9]陈彩蓉,王秋香,邱佩嫦,等.多囊卵巢综合征合并不孕与子宫内膜病变关系的临床探讨.中国妇幼保健,2012,27(21):3291-3293.
[10]Minagawa K,Watanabe T,Oyanagi R.Characteristics of women with epilepsy who developed polycystic ovary syndrome owing to the therapy with valproate sodium.No To Hattatsu,2013,45(4):304-308.
[11]李昱川.多囊卵巢综合征患者脂代谢紊乱与体重、胰岛素抵抗和雄激素水平的关系.中国妇幼保健,2014,29(3):354-356.
[12]张庆芳.腹腔镜卵巢打孔联合药物治疗难治性多囊卵巢综合征临床分析.中国内镜杂志,2014,20(4):411-413.
[13]郭政,王丽英,李华.腹腔镜卵巢打孔术联合中药治疗多囊卵巢综合征不孕的疗效分析.中国妇幼保健,2015,30(12):1931-1932.
[14]谢秀敏,朱卫华,江容.腹腔镜下卵巢打孔术治疗多囊卵巢综合征合并不孕症的有效性及安全性.广东医学,2013,34(15):2373-2375.
[15]蒋建发,孙爱军.多囊卵巢综合征手术治疗的利与弊.中国实用妇科与产科杂志,2013,29(11):856-860.
[16]冯月枝,张清学.PCOS患者卵巢打孔对卵巢储备功能的影响.实用妇产科杂志,2012,28(6):425-426.
[17]张婷,许彦来.补肾活血清肝方联合氯米芬治疗多囊卵巢综合征90例临床观察.中国中医基础医学杂志,2014,20(2):266-267,282.
[18]冯月枝,李琳,李予,等.腹腔镜卵巢打孔对多囊卵巢综合征患者体外受精结局的影响.广东医学,2013,34(1):18-21.
[19]李建青,丁鸿燕,徐雪泉,等.多囊卵巢综合征患者血清胰岛素、性激素的水平及其临床意义.中国卫生检验杂志,2013,23(5):1236-1237,1338.