腹腔鏡卵巢率泡燒灼打孔術治療多囊性卵巢症候群患者六年半的臨床經驗分析

Laparoscopic Ovarian Drilling with Diathermy in the Treatment of Patients with Polycystic Ovary Syndrome: Six and Half Years Clinical Experienced Analysis

汪文生(Wen-Sheng Wang)

《童綜合醫學雜誌》 1卷1期 (2007/12) Pp. 33-38

https://doi.org/10.29838/TMJ.200712.0006

摘要

目的：評價腹腔鏡卵巢濾泡燒灼打孔術對排卵藥物產生耐藥性（clomiphene resistant）的多囊性卵巢症候群（polycystic ovary syndrome, PCOS）患者所產生的療效。對象、方法：以回溯性研究收集2001年3月至2007年8月在本院婦產科不孕症門診就醫的多囊性卵巢症候群患者，確定診斷為PCOS是其不孕的主要原因，並且對排卵刺激藥物反應不良之不孕症患者共20例，接受腹腔鏡卵巢濾泡燒灼打孔術（laparoscopic ovarian drilling with diathermy, LOD）的治療並評估治療後的懷孕率、流產率、以及再次懷孕的機率。結果：懷孕率達60%（12/20）其中自然受孕的有50%（6/12），生下健康寶寶的機率91.7%（11/12），流產率8.3%（1/12），LOD術後第一次懷孕後的12位婦女當中有8位想再次懷孕，其中有5位自然受孕成功並順利生產，想再次自然懷孕的機率有62.5%（5/8）。結論：對藥物治療無效以及想要再次或多次懷孕的多囊性卵巢症候群患者，腹腔鏡卵巢濾泡燒灼打孔術是優先考慮的選擇。

關鍵字

燒灼 ； 腹腔鏡 ； 卵巢打孔術 ； 多囊性卵巢症候群

並列摘要

Objective: To evaluate the effect of laparoscopic ovarian drilling with diathermy on the pregnancy out come of polycystic ovary syndrome in clomiphene-resistant infertile women.Methods: Twenty anovulatory infertility women with polycystic ovary syndrome who visited the Tungs' Taichung MetroHarbor Hospital between March 2001 and August 2007. All patients had been unresponsive to treatment with clomiphene citrate. Laparoscopic ovarian drilling with diathermy was performed. The rates of pregnancy, abortion and once again pregnancy were calculated.Results: Pregnancy rate 60% (12/20) and 6 of the 12 pregnancy women (50%) were spontaneous pregnancy, take baby home rate 91.7% (11/12), abortion rate 8.3% (1/12), sequential pregnancy rate 62.5% (5/8).Conclusion: Laparoscopic ovarian drilling with diathermy can be the good choice for antioestrogen resistant anovulatory infertility in women with the polycystic ovary syndrome who want to conception twice or more.

並列關鍵字

diathermy ； laparoscopy ； ovarian drilling ； polycystic ovary syndrome