多囊性卵巢症候群的手術治療

Surgical Treatment of Polycystic Ovary Syndrome

陳星佑(Hsing-Yu Chen) ； 余堅忍(Ken-Jen Yu)

《北市醫學雜誌》 3卷4期 (2006/04) Pp. 359-366

https://doi.org/10.6200/TCMJ.2006.3.4.06

摘要

多囊性卵巢症候群的手術治療現今以腹腔鏡卵巢鑽孔術為主，與促性腺素的療法相比，在排卵率、活產率、流產率及未來的懷孕率並沒有差別，但可以減少多胞胎及卵巢過度刺激症候群的發生，亦可減少醫療之花費，而其風險了一般腹腔鏡手術及麻醉的風險外，術後的粘連與懷孕率，以及手術造成的卵巢早期衰竭並沒有明顯的意義。至於其機轉可能是因為術後的雄性素下降，而使得術後有良好的排卵率及懷孕率，同時也使得高胰島素血症的多囊性卵巢症候群病人在手術後的血糖值及胰島素值下降。至於鑽孔的方法，以電燒較雷射的方法為佳。而卵巢鑽洞的數量及使用的能量則沒有一個標準。至於術後所能維持的時間，大多數均能維持至9年之久。

關鍵字

多囊性卵巢症候群 ； 手術 ； 卵巢鑽孔

並列摘要

Laparoscopic ovarian drilling is the operation of polycystic ovarian syndrome nowadays. There are no differences about ovulation rate, live births rate, miscarriage rate and ongoing pregnancy rate between the laparoscopic ovarian drilling and gonadotropin therapy, but the operation can decreased the incidence of multiple pregnancy rate and ovarian hyperstimulation syndrome. The risks of the operation included the risks and morbidity of the laparoscopy under general anaesthesia, but there is no significance about postoperative adhesion formation and pregnant rate, and operation-induced premature ovarian failure. The mechanism of the operation might be due to drop of the androgen postoperatively, with good ovulation rate and pregnant rate. It also lowers the value of blood sugar and insulin of the PCOS patient with hyperinsulinemia. The operation can be used better with electrocauterization than with laser. There is no standard about the number of drilling and the energy used. The effect of laparoscopic ovarian drilling can be maintained for about 9 years.

並列關鍵字

PCOS ； surgery ； ovarian drilling