目的: 系统评价代谢手术对肥胖型多囊卵巢综合征的影响。方法: 检索 PubMed、EMBASE、Cochrane Library、CNKI 和万方数据库。检索时间为 2000－01 ～ 2017－05。结局指标包括 PCOS、月经周期异常、多毛症、不 孕症。结果: 纳入的 19 篇报道中，共纳入接受代谢手术病人共 2716 例，其中女性病人 2274 例。经代谢手术后， PCOS 发生率术前12．27%术后降低为4．76%( 95%CI: 2．14 ～ 9．86，Z = 3．92，P＜0．0001) 。月经周期异常发生率术前 34．43%术后降低为10．79%( 95%CI: 5．62～ 26．15，Z= 6．36，P＜0．0001) 。多毛症发生率70．59%降低为21．01%( 95% CI: 3．57～ 31．06，Z= 4．27，P＜0．0001) 。不孕症发生率7．69%术后降低为2．56% ( 95% CI: 1．77 ～ 5．81，Z = 3．85，P = 0．0001) 。结论: 代谢手术可显著改善肥胖型多囊卵巢综合征的临床症状。

Objective: To review the effect of metabolic surgery for the treatment polycystic ovarian syndrome( PCOS) ．Methods: A comprehensive search of electronic databases about metabolic surgery and PCOS was completed．Electronic literature search was performed on PubMed，EMBASE，Cochrance Library，CNKI and Wanfang from January 1，2000 to May 1，2017．Meta－analysis was performed on P- COS，menstrual irregularity，hirsutism，and inferility outcomes．Ｒesults: Among all the 19 included stud- ies，a total of 2716 cases were reported，including 2274 female patients．The incidence of PCOS preoper- atively was 12．27%，which significantly decreased postoperatively to 4．76%( 95%CI: 2．14 ～ 9．86，Z = 3．92，P ＜ 0．0001 ) ． The incidence of menstrual irregularity preoperatively was 34．43%，which significantly decreased postoperatively to 10．79%( 95%CI: 5．62～26．15，Z = 6．36，P＜0．0001) ．The inci- dence of hirsutism preoperatively was 70．59%，which decreased significantly postoperatively to 21．01% ( 95%CI: 3．57 ～ 31．06，Z = 4．27，P ＜ 0．0001) ． The incidence of inferility preoperatively was 7．69%， which decreased significantly postoperatively to 2．56% ( 95% CI: 1．77 ～ 5．81，Z = 3．85，P = 0．0001) ． Conclusion: Bariatric surgery effctively attenuates PCOS and its clinical sympomatology in abnomal obese women．

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收稿日期: 2018－05－26; 修回日期: 2019－02－20 基金项目: 北京市科委 2015 年“首都临床特色”专项立项课题( Z151100004015065) 作者简介: 刘欢妹( 1989－) ，女，首都医科大学附属北京友谊医院 2015 级在读硕士研究生。 通讯作者: 孟化，主任医师，硕士研究生导师，E－mail: menghuade@ hotmail．com 中日友好医院普外科，100029