腹腔镜卵巢电灼术与枸橼酸氯米酚加二甲双胍作为多囊卵巢综合征排卵障碍患者二线治疗策略的比较：一项随机对照试验。
Laparoscopic ovarian diathermy vs clomiphene citrate plus metformin as second-line strategy for infertile anovulatory patients with polycystic ovary syndrome: a randomized controlled trial.
机构信息
Department of Obstetrics and Gynecology, University Magna Graecia of Catanzaro, Catanzaro, Italy.
出版信息
Am J Obstet Gynecol. 2010 Jun;202(6):577.e1-8. doi: 10.1016/j.ajog.2009.11.042. Epub 2010 Jan 22.
OBJECTIVE
The purpose of this study was to compare the effectiveness of laparoscopic ovarian diathermy (LOD) vs clomiphene citrate (CC) plus metformin in infertile patients with CC-resistant polycystic ovary syndrome (PCOS).
STUDY DESIGN
Fifty primary infertile patients with CC-resistant PCOS were assigned randomly to receive LOD followed by a 6-month observation (group A) or 6-cycle course of CC plus metformin (group B). Reproductive and safety outcomes were analyzed.
RESULTS
No significant difference between 2 groups in pregnancy (15/92 women [16.3%] vs 14/107 women [13.1%]; P = .521) and live-birth (13/92 women [14.1%] vs 12/107 women [11.2%]; P = .536) rates per cycle was observed. With the use of a Cox regression analysis, patients under medical treatment, compared with patients who received surgical treatment, had a relative risk of pregnancy of 1.2 (95% confidence interval, 0.61-2.44; P = .582) and a relative risk of live-birth of 1.4 (95% confidence interval, 0.63-2.96; P = .425).
CONCLUSION
LOD and CC plus metformin seem to be 2 effective approaches to treat infertility in patients with CC-resistant PCOS.
目的
本研究旨在比较腹腔镜卵巢电灼术（LOD）与枸橼酸氯米酚（CC）加二甲双胍在 CC 抵抗型多囊卵巢综合征（PCOS）不孕患者中的疗效。
设计
将 50 例 CC 抵抗型 PCOS 原发性不孕患者随机分为接受 LOD 后观察 6 个月（A 组）或接受 CC 加二甲双胍 6 个周期治疗（B 组）。分析生殖结局和安全性。
结果
两组妊娠率（15/92 例女性[16.3%] vs 14/107 例女性[13.1%]；P=0.521）和活产率（13/92 例女性[14.1%] vs 12/107 例女性[11.2%]；P=0.536）差异无统计学意义。采用 Cox 回归分析，与接受手术治疗的患者相比，接受药物治疗的患者妊娠的相对风险为 1.2（95%置信区间，0.61-2.44；P=0.582），活产的相对风险为 1.4（95%置信区间，0.63-2.96；P=0.425）。
结论
LOD 和 CC 加二甲双胍似乎是治疗 CC 抵抗型 PCOS 不孕患者的两种有效方法。
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