Clinical efficiency of laparoscopic ovarian perforation combined with clomiphene citrate and human chorionic gonadotropin in treating infertility induced by polycystic ovary syndrome
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摘要:目的 探讨腹腔镜下卵巢打孔术配合克罗米芬(CC)、人绒毛膜促性腺激素(HCG)对多囊卵巢综合征(PCOS)所致不孕症的治疗效果。方法 将68例PCOS所致不孕症患者随机分为2组, 每组34例。对照组行腹腔镜下卵巢打孔术与HCG治疗，观察组行腹腔镜下卵巢打孔术配合CC、HCG治疗。比较2组患者治疗效果及妊娠情况。结果 治疗后，观察组黄体生成激素、雌二醇、睾酮等指标均显著优于对照组(P < 0.05)。观察组治疗期间排卵率为91.18%, 1年内妊娠率58.82%, 均显著高于对照组的58.82%、32.35%(P < 0.05)。对照组未见不良反应，观察组不良反应发生率5.58%, 2组不良反应发生率无显著差异(P>0.05)。结论 腹腔镜下卵巢打孔术配合CC、HCG对PCOS所致不孕症有显著的治疗效果，可改善性激素水平，提高排卵率及妊娠率。Abstract:Objective To explore the clinical efficiency of laparoscopic ovarian perforation combined with clomiphene citrate (CC) and human chorionic gonadotropin (HCG) in treating infertility induced by polycystic ovary syndrome (PCOS).Methods Totally 68 patients with infertility induced by PCOS were randomly divided into two groups, with 34 cases in each group. The control group was treated with laparoscopic ovarian perforation and HCG, while the observation group was treated with laparoscopic ovarian perforation combined with CC and HCG. Therapeutic effect and pregnancy condition were compared between the two groups.Results After treatment, the levels of luteinizing hormone, estradiol and testosterone in the observation group were significantly better than those in the control group (P < 0.05). In the observation group, the ovulation rate and one-year pregnancy rate were 91.18% and 58.82% respectively, which were significantly higher than 58.82% and 32.35% in the control group (P < 0.05). There were no adverse reactions in the control group, and the incidence rate of adverse reactions in the observation group was 5.58%. There was no significant difference between the two groups (P>0.05).Conclusion Laparoscopic ovarian perforation combined with CC and HCG is effective in the treatment of infertility induced by PCOS, which can improve sex hormone level and increase ovulation rate and pregnancy rate.
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表 1 2组治疗前后血清性激素水平比较(x±s)
组别 LH/(IU/L) FSH/(IU/L) E2/(mmol/L) T/(pmol/L) 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 对照组(n=34) 18.13±2.05 8.71±1.03 6.30±1.02 6.19±1.01 188.67±15.30 175.37±12.74 4.59±1.04 1.89±1.07 观察组(n=34) 18.07±2.14 8.10±1.02* 6.28±1.05 6.20±1.04 188.71±15.24 170.24±11.63* 4.61±1.10 1.25±1.11* LH: 促黄体生成激素; FSH: 卵泡雌激素; E2: 雌二醇; T: 睾酮。与对照组比较, *P < 0.05。 
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表 2 2组排卵情况及妊娠情况比较[n(%)]
组别 n 治疗周期内排卵 1年内妊娠 对照组 34 20(58.82) 11(32.35) 观察组 34 31(91.18)* 20(58.82)* 与对照组比较, *P < 0.05。
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