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目的:探讨腹腔镜辅以来曲唑治疗难治性多囊卵巢综合征(PCOS)不孕的治疗效果。方法:将2010年1月～2011年12月120例诊断为难治性PCOS的患者随机分为研究组和对照组各60例。研究组采用腹腔镜打孔联合来曲唑促排卵治疗,对照组采用单纯腹腔镜打孔术。在治疗前及治疗后监测患者的基础雌二醇(E2),促卵泡生成激(FSH)、促黄体生成激素(LH)、睾酮(T)以及基础体温(BBT),并利用B超监测卵泡发育和排卵情况。结果:研究组和对照组治疗后较治疗前FSH均明显升高,LH/FSH的比值显著下降,睾酮水平也明显下降(P<0.05)。研究组和对照组患者的E2水平治疗后较治疗前下降(P<0.05),且研究组下降更为显著(P<0.05)。对照组术后进行BBT和B超监测排卵显示排卵率为68.6%,妊娠率为46.7%,而研究组的排卵率为92.9%,妊娠率达98.3%,明显高于对照组(P<0.01)。结论:腹腔镜辅以来曲唑治疗难治性多囊卵巢综合征不孕可以明显降低患者的LH、E2及睾酮的水平,增加FSH水平,有效改善难治性PCOS患者的生殖内环境,提高排卵率和妊娠率,值得在临床推广应用。
Objective: To investigate the effect of laparoscopy with letrozole in the treatment of refractory polycystic ovary syndrome (PCOS) infertility. Methods: One hundred and twenty patients diagnosed as refractory PCOS between January 2010 and December 2011 were randomly divided into study group (60 cases) and control group (60 cases). The study group laparoscopic combined with letrozole ovulation therapy, the control group using simple laparoscopic drilling. The patients’ basal estradiol (E2), follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T) and basal body temperature (BBT) were monitored before and after treatment. Development and ovulation. Results: Compared with before treatment, the FSH in study group and control group were significantly increased after treatment, the ratio of LH / FSH was significantly decreased, testosterone level was also significantly decreased (P <0.05). E2 levels of study group and control group decreased after treatment (P <0.05), and the study group decreased more significantly (P <0.05). In the control group, the ovulation rate was 68.6% after BBT and B-ultrasound monitoring, the pregnancy rate was 46.7%, while that of the study group was 92.9% and the pregnancy rate was 98.3%, significantly higher than that of the control group (P <0.01) . Conclusions: Laparoscopy combined with letrozole in the treatment of refractory PCOS can significantly reduce the levels of LH, E2 and testosterone, increase the level of FSH, effectively improve the reproductive environment and improve ovulation in patients with refractory PCOS Rate and pregnancy rate, it is worth in the clinical application.