卵巢过度刺激综合征55例临床分析

Clinical Analysis of 55 Cases on Ovarian Hyperstimulation Syndrome

目的探讨卵巢过度刺激综合征(ovarian hyperstimulation syndrome,OHSS)的发病机制、临床表现、预防及治疗措施。方法本研究对2005年1月至2008年2月在本院住院治疗的55例OHSS患者进行回顾性分析,根据OHSS发生时间,将其分为早发组和晚发组,早发组患者为31例(31/55,56.4%),晚发组为24例(24/55,43.6%)。并比较两组间患者的特征和实验室资料。结果早发组注射HCG当日雌二醇水平高于晚发组,两组比较,差异有显著意义(P<0.05)。晚发组临床妊娠率(91.6%)、多胎妊娠率(16.7%)和重度OHSS率(41.6%)均高于早发组(P<0.05)。结论早发OHSS,主要与在促排卵治疗过程中外源性HCG刺激有关;晚发OHSS,则更多与妊娠(尤其是多胎妊娠)产生的内源性HCG相关,更易发生重度OHSS。使用促排卵药物时,应注意预防OHSS,降低中、重度OHSS发生率。

Objective To investigate the pathogenesis, characteristics, prevention and treatment of ovarian hyperstimulation syndrome （OHSS）. Methods From January 2005 to February 2008, 55 cases of OHSS inpatients were retrospectively analyzed in the West China Second Hospital. The patients were divided into early OHSS group and late OHSS group according to the onset time of OHSS. The clinical characteristics and laboratory data were compared between 2 groups. Results Early OHSS occurred in 31 patients（31/55,56.4%）, and late OHSS complicated in 24 patients（24/55,43.6%）. The estradiol level on the day of HCG administration was significantly higher in the early OHSS group（P〈0.05）. The clinical pregnancy rate（91.6%）,multiple pregnancy rate（16.7%）and severe OHSS rate（41. 6% ）in the late OHSS group were significantly higher than that of the early OHSS group. Conclusion The early OHSS is associated with exogenous HCG in controlled ovarian hyperstimulation （COH）, and late OHSS is more closed associated with the conception cycle, especially multiple pregnancy, and more likely to be severe. Prevention of OHSS should be taken into account in COH to reduce the incidence of moderate and severe OHSS.