中心静脉导管腹腔留置在重度卵巢过度刺激综合征合并张力性腹水中的临床应用

Clinical Application of Using Tiny Central Venous Indwelling Catheter Drainage in Treating Sever Ovarian Hyperstimulation Syndrome Company with Tense Ascites

目的:探讨中心静脉导管腹腔留置治疗重度卵巢过度刺激综合征(OHSS)合并张力性腹水的疗效。方法:将21例重度OHSS合并张力性腹水患者随机分为置管组和对照组。置管组(10例)在B超监视下采用Seldinger法置入中心静脉导管持续腹腔引流,同时联合扩容、对症等综合治疗;对照组则采用传统穿刺进行腹腔引流,观察其临床疗效。结果:置管组置管一次性成功率100%,置管引流后所有患者腹胀、纳差、呼吸困难症状均快速缓解,腹围及体质量较前明显下降(P<0.01),24 h尿量增多(P<0.01),平均置管天数为7.9±2.0 d,平均住院天数为10.6±2.7 d。与传统穿刺对照组比平均住院天数(12.2±2.3 d)稍有缩短(P>0.05),治疗费用明显降低(P<0.05)。除1例发生穿刺点腹水渗漏外,无其他严重并发症。结论:采用微创中心静脉导管腹腔留置治疗OHSS合并张力性腹水安全简便、经济有效,是一种可行方法。

Objective： To evaluate the value of treating severe ovarian hyperstimulation syndrome（OHSS） company with tense ascites by tiny central venous indwelling catheter drainage.Methods： Ten patients of severe OHSS company with tense ascites were detained central venous indwelling catheter in the abdominal cavity by seldinger way under the guidance of ultrasound.All patients combined supportive treatment.The clinical curative effect and the biochemical indicators of drainage group were compared with conventional therapy group.Results： The symptoms of abdominal distension,loss of appetite,dyspnea were complete or partial remission in drainage group.The weight and abdomen circumference of drainage group after therapy were significantly lower than those before therapy,and the volum of 24 h urine increased significantly.Average tube detaining time was 7.9±2.0 d and hospital day was 10.6±2.7 d.Average hospital day and cost of drainage group were decreased compared with conventional therapy group.No serious complication happened,but with one case of persistent leakage around the catheter.Conclusion： The central venous indwelling catheter drainage for severe OHSS company with tense ascites is an effective method,which has the advantages of safety and simple,minor invasion,better curative effect,lower medical expense and less complication.