45例中重度卵巢过度刺激综合征临床分析

Clinical analysis of ovarian hyperstimulation syndrome in 45 controlled ovarian super-stimulation cycles

目的:探讨在辅助生育治疗过程中中重度卵巢过度刺激综合征的特征以及防治疗方法。方法:回顾性分析我院生殖中心自2001年10月-2005年6月发生的45例中重度OHSS的临床资料。结果:在653个超排周期中有45例发生中重度OHSS(发生率为6.89%),临床表现主要为卵巢体积增大、体重增加、恶心呕吐、腹痛、腹胀、腹泻,重者出现胸腹水、呼吸因难、血液浓缩等,OHSS患者和无OHSS患者FSH的用量分别是(26.42±9.90)支和(29.67±9.63)支,P<0.05;HCG日E2水平分别是(3 302.53±1 944.05)pg/m l和(2 487.72±1 901.19)pg/m l,P<0.01;获卵数分别是(16.82±7.83)个和(12.37±7.27)个,P<0.01;临床妊娠率分别是66.7%(30/45)和28.9%(176/608),P<0.01。妊娠组患者中重度OHSS的发生率显著高于非妊娠组,发生率分别是14.6%(30/206)和3.4%(15/447),P<0.01。结论:在促排卵治疗过程中,要注意OHSS,及早采取防治措施,保护患者的生命安全。

Objective ： To investigate the high risk factors and methods of prevention and treatment of ovarian hyperstimulation syndrome （OHSS） during assisted reproduction techniques therapy （ART） . Methods： Retrospectively analyzed the clinical data of 45 cycles of moderate and severe OHSS patients after in vitro fertilization - embryo transfer （ IVF - ET） from 2001 to 2005 in this center. Results： There were 45 moderate and severe OHSS cycles in 653 controlled ovarian super - stimulation cycles, the incident rate was 6. 89%. The main manifestations included increased volume of ovarian, weight gain, nausea, abdominal pain, abdominal distension, diarrhea, even ascites, pleura] effusion, or dyspnoea. The moderate and severe OHSS patients received significantly lower treatment doses of recombinant FSH （26. 42±9. 90 ampoules versus 29. 67±9. 63 ampoules, P 〈0. 05）, the serum E2 levels of HCG day were significantly higher than that in general patients [ （3 302. 53±1 944. 05） pg/ml versus （2 487. 72 ±1 901. 19） pg/ml, P 〈0. 01 ） ], had significantly more eggs collected （16. 82±7. 83 versus 12. 37±7. 27, P〈0. 01）, and obtained higher clinical pregnant rate （66. 7% versus28. 9%, P 〈0. 01 ）. Meanwhile, the incident rate of moderate and severe OHSS was significantly higher in pregnant patients than those in non - pregnant patients （ 14. 6% versus 3. 4% , P 〈0. 01 ） . Conclusion： More attention should be paid to OHSS during pro - ovulation treatment to take prevention and cure measures to protect the patient＇s life.