目的 探讨辅助生育技术中的卵巢过度刺激综合征(OHSS)的诱因及临床监测与治疗方法。
方法 对我院136例患者中、重度卵巢过度刺激综合征临床资料进行回顾性分析。结果 (1) OHSS 发生的高危因素: 双侧卵巢被激发过多卵泡、应用人绒毛膜促性腺激素(hCG)以及妊娠。(2) OHSS 大多发生在应用促排卵药物后3~10 d。(3) 妊娠患者OHSS 病程长、症状重、白蛋白应用量大。(4) 扩容防血液浓缩、静脉滴注白蛋白为治疗OHSS 的有效措施;重症患者穿刺引流胸腹水可缓解症状。结论 OHSS 为促超排卵引起的严重并发症,应予正确防治。
Objective To investigate the high risk factors, clinical manifestation and therapy strategy of ovarian hyperstimulation syndrome (OHSS) in assisted reproduction techniques (ART). Methods Clinical data of 136 cycles of OHSS patients after in vitro fertilization-embryo transfer (IVF-ET) from 2005 to 2008 were analyzed retrospectively. Results (1) A large number of follicles stimulated, luteal phase supported with hCG and pregnancy were high risk factors to induce OHSS. (2) Most of OHSS occurred on the 3rd day to 10th day after administration of medicine to induce ovulation. (3) Longer disease process, more severe symptoms and larger amount albumin used for treatment of OHSS were commonly observed in pregnant patients with OHSS compared with non-pregnant ones. (4) Human serum albumin through intravenous dripping was one of the most successful treatment as plasma expanders through restoration of effective blood volume; paracentesis was necessary for critical OHSS patients with severe ascites and hydrothorax. Conclusions OHSS is a serious complication of controlled ovarian hyperstimulation, which deserves proper prevention and treatment.