中国医药
中國醫藥
중국의약
CHINA MEDICINE
2014年
2期
253-257
,共5页
孙秀芬%朱立华%常玉婷%周军英
孫秀芬%硃立華%常玉婷%週軍英
손수분%주립화%상옥정%주군영
多囊卵巢综合征%未成熟卵泡穿刺术%口服避孕药
多囊卵巢綜閤徵%未成熟卵泡穿刺術%口服避孕藥
다낭란소종합정%미성숙란포천자술%구복피잉약
Polycystic ovarian syndrome%Immature follicle puncture%Oral contraceptive
目的 探讨未成熟卵泡穿刺术(IMFP)治疗多囊卵巢综合征(PCOS)不孕患者的可行性和有效性.方法 选择2009年4月至2011年3月在山东省聊城市第二人民医院生殖科接受诊疗并确诊的PCOS不孕患者共149例,分为对照组(74例)和研究组(75例).对照组应用炔雌醇环丙孕酮片治疗,l片/d,1个周期21 d,用药期间每4周复诊1次,3个周期后指导同房.研究组应用炔雌醇环丙孕酮片治疗3个周期(用药方案同对照组),停药3个月内未见优势卵泡者,给予促排卵治疗后,行IMFP.分别记录2组治疗前后性激素水平、卵巢体积大小及窦卵泡数目变化以及治疗后月经恢复情况、排卵及妊娠率.结果 2组治疗后性激素水平均得到不同程度改善,但差异无统计学意义(P＞0.05);研究组和对照组卵巢体积及基础窦卵泡计数治疗后较治疗前明显减少[研究组:(4.3±0.8)cm3比(5.5±0.4) cm3,(10.2±2.6)个比(13.9±2.3)个,对照组:(4.0±0.4) cm3比(4.4±0.4)cm3,(12.0±3.0)个比(14.3±3.1)个](P＜0.05),并且研究组卵巢体积及窦卵泡计数变化明显大于对照组[(4.0±2.9)cm3比(2.9±2.6)cm3,(14.2±5.4)个比(7.9±4.3)个](P＜0.05);研究组月经恢复、排卵及妊娠率明显高于对照组[50.1％(38例)比32.4％(29例),排卵率为73.3％(55例)比55.4％(41例),妊娠率为44.2％(33例)比28.3％(21例)](均P ＜0.05).结论 IMFP和炔雌醇环丙孕酮片在治疗PCOS不孕方面疗效均确切,但IMFP在减小卵巢体积、减少窦卵泡数、改善月经、恢复排卵及促进妊娠方面优于炔雌醇环丙孕酮片.
目的 探討未成熟卵泡穿刺術(IMFP)治療多囊卵巢綜閤徵(PCOS)不孕患者的可行性和有效性.方法 選擇2009年4月至2011年3月在山東省聊城市第二人民醫院生殖科接受診療併確診的PCOS不孕患者共149例,分為對照組(74例)和研究組(75例).對照組應用炔雌醇環丙孕酮片治療,l片/d,1箇週期21 d,用藥期間每4週複診1次,3箇週期後指導同房.研究組應用炔雌醇環丙孕酮片治療3箇週期(用藥方案同對照組),停藥3箇月內未見優勢卵泡者,給予促排卵治療後,行IMFP.分彆記錄2組治療前後性激素水平、卵巢體積大小及竇卵泡數目變化以及治療後月經恢複情況、排卵及妊娠率.結果 2組治療後性激素水平均得到不同程度改善,但差異無統計學意義(P＞0.05);研究組和對照組卵巢體積及基礎竇卵泡計數治療後較治療前明顯減少[研究組:(4.3±0.8)cm3比(5.5±0.4) cm3,(10.2±2.6)箇比(13.9±2.3)箇,對照組:(4.0±0.4) cm3比(4.4±0.4)cm3,(12.0±3.0)箇比(14.3±3.1)箇](P＜0.05),併且研究組卵巢體積及竇卵泡計數變化明顯大于對照組[(4.0±2.9)cm3比(2.9±2.6)cm3,(14.2±5.4)箇比(7.9±4.3)箇](P＜0.05);研究組月經恢複、排卵及妊娠率明顯高于對照組[50.1％(38例)比32.4％(29例),排卵率為73.3％(55例)比55.4％(41例),妊娠率為44.2％(33例)比28.3％(21例)](均P ＜0.05).結論 IMFP和炔雌醇環丙孕酮片在治療PCOS不孕方麵療效均確切,但IMFP在減小卵巢體積、減少竇卵泡數、改善月經、恢複排卵及促進妊娠方麵優于炔雌醇環丙孕酮片.
목적 탐토미성숙란포천자술(IMFP)치료다낭란소종합정(PCOS)불잉환자적가행성화유효성.방법 선택2009년4월지2011년3월재산동성료성시제이인민의원생식과접수진료병학진적PCOS불잉환자공149례,분위대조조(74례)화연구조(75례).대조조응용결자순배병잉동편치료,l편/d,1개주기21 d,용약기간매4주복진1차,3개주기후지도동방.연구조응용결자순배병잉동편치료3개주기(용약방안동대조조),정약3개월내미견우세란포자,급여촉배란치료후,행IMFP.분별기록2조치료전후성격소수평、란소체적대소급두란포수목변화이급치료후월경회복정황、배란급임신솔.결과 2조치료후성격소수평균득도불동정도개선,단차이무통계학의의(P＞0.05);연구조화대조조란소체적급기출두란포계수치료후교치료전명현감소[연구조:(4.3±0.8)cm3비(5.5±0.4) cm3,(10.2±2.6)개비(13.9±2.3)개,대조조:(4.0±0.4) cm3비(4.4±0.4)cm3,(12.0±3.0)개비(14.3±3.1)개](P＜0.05),병차연구조란소체적급두란포계수변화명현대우대조조[(4.0±2.9)cm3비(2.9±2.6)cm3,(14.2±5.4)개비(7.9±4.3)개](P＜0.05);연구조월경회복、배란급임신솔명현고우대조조[50.1％(38례)비32.4％(29례),배란솔위73.3％(55례)비55.4％(41례),임신솔위44.2％(33례)비28.3％(21례)](균P ＜0.05).결론 IMFP화결자순배병잉동편재치료PCOS불잉방면료효균학절,단IMFP재감소란소체적、감소두란포수、개선월경、회복배란급촉진임신방면우우결자순배병잉동편.
Objective To evaluate the efficacy and feasibility of transvaginal ultrasound-guided immature follicle puncture (IMFP) on polyeystic ovary syndrome (PCOS) with infertility.Methods One hundred and fortynine patients diagnosed of PCOS with infertility were included from April 2009 to March 2011.74 patients of control group had a piece of the oral desogestrel and ethinylestradiol tablets (diane-35).Further consultation was performed every four weeks.The patients without domiminant follicle in 3 months after medicine administration were treated with IMFP after ovulation induction therapy.Serum hormone level,the change of the ovary volume and basic follicle number were recorded before and after treatment.Menstruation recovery ovulation and pregnancy rate were recorded after treatment.Results Serum hormone level was ameliorated but without statistical difference (P ＞ 0.05) ; ovary volume and the basic follicle number were decreased in patients of both groups after treatment [study group:(4.3 ± 0.8) cm3 vs (5.5 ± 0.4) cm3,(10.2 ± 2.6) vs (13.9 ± 2.3),control group:(4.0 ±0.4)cm3 vs (4.4 ±0.4)cm3,(12.0 ±3.0) vs (14.3 ±3.1)] (P ＜0.05) and there were significant differences in the rate of change of ovary volume and the basic follicle number between two groups (P ＜ 0.05).Menstruation recovery,ovulation and pregnancy were also improved significantly in both groups after treatment[50.1％ (38 cases) vs 32.4％ (29 cases),73.3％ (55 cases) vs 55.4％ (41 cases),44.2％ (33 cases) vs 28.3％ (21 cases)](P ＜ 0.05).Conclusions The IMFP and oral contraceptive treatment are both feasible for PCOS with infertility.However,IMFP treatment is better than oral contraceptive regarding decreasing the basic follicle number,the ovary volume,menstruation recovery,spontaneous ovulation rate and the pregnancy rate.
