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目的探讨腹腔镜治疗多囊卵巢综合征术后药物治疗的重要性。方法将32例患者随机分为A组(腹腔镜卵巢打孔术)14例,B组[腹腔镜下卵巢打孔术+氯米芬(CC)+促性腺激素]18例。手术前后分别测血黄体生成素(LH)、血卵泡刺激素(FSH)、睾酮(T)及雌激素(E2)水平,术后第10天起监测患者卵泡发育和排卵共3个周期,并记录排卵数和妊娠数。结果两组患者术后LH和T水平均有显著下降(P<0.01)。3个治疗周期共有25例排卵,其中A组8例(57.1%),B组17例(94.4%),两组排卵率差异有统计学意义(P<0.05)。1年内累计妊娠17例,其中A组4例,B组13例。结论腹腔镜术后结合药物治疗能明显改善难治性PCOS患者的排卵和受孕机会,术后应早期药物诱发排卵,以免错过手术后怀孕的最佳时机。
Objective To explore the importance of laparoscopic treatment of polycystic ovary syndrome after drug treatment. Methods Thirty-two patients were randomly divided into group A (laparoscopic ovarian drilling) in group A (group B), group B (laparoscopic ovarian drilling + clomiphene (CC) + gonadotropin] in 18 cases. Blood LH, FSH, T and E2 levels were measured before and after surgery. Follicular development and ovulation were monitored on the 10th day after operation for a total of 3 cycles Record the number of ovulation and pregnancy. Results The postoperative LH and T levels of both groups were significantly decreased (P <0.01). There were 25 ovulation cases in 3 cycles, including 8 cases in group A (57.1%) and 17 cases in group B (94.4%). There was significant difference in ovulation rate between the two groups (P <0.05). 17 cases of pregnancy in 1 year, including 4 cases in group A and group B in 13 cases. Conclusion Combined laparoscopic surgery can significantly improve the chances of ovulation and conception in patients with refractory PCOS. Early postoperative ovulation induction should be avoided in order to avoid missing the best time for pregnancy after surgery.