留置中心静脉导管腹水引流治疗中重度卵巢过度刺激综合征合并张力性腹水的临床应用

Clinical application of indwelling central venous catheter ascites drainage in the treatment of severe OHSS complicated with tension ascites

目的回顾性分析留置中心静脉导管(CVC)腹水引流治疗中重度卵巢过度刺激综合症(OHSS)合并张力性腹水的临床疗效。方法将本中心2009年1月-2011年6月、2004年6月-2008年12月收治的中重度OHSS合并张力性腹水患者分别作为置管组(n=10)、对照组(n=15)。置管组采用CVC腹腔留置引流腹水,对照组采用传统多次腹腔穿刺引流腹水,评价临床疗效。结果置管组均一次性置管成功,引流腹水后患者腹胀明显缓解,腹围、体重、红细胞压积、尿比重均明显下降,24 h尿量明显增多;与对照组比较,治疗5 d患者腹围明显减小、腹水引流量及总引流次数增多、病程有所缩短,且置管组无特殊并发症。结论采用CVC腹腔留置引流治疗中重度OHSS合并张力性腹水患者效果良好,且方便、安全、经济,患者依从性好,值得推广。

Objective To retrospectively analyze the clinical efficacy of indwelling central venous catheter （CVC） ascites drainage in the treatment of ovarian hyperstimulation syndrome （OHSS） complicated with tension ascites. Methods The patients with OHSS complicated with tension ascites from January 2009 to June 2011 and June 2004 to December 2008 in our center were selected and divided into catheter group （n = 10） and control group （ n = 15）. The catheter group received CVC abdominal cavity with drainage of ascites, while the control group received the tradi- tional multiple abdominal puncture drainage of ascite. The clinical effects of the two groups were e- valuated. Results The catheter group had successful disposable catheters. There was significant ease of abdominal distension after ascites drainage. The abdominal circumference, weight, HCT, urine specific gravity significantly decreased, and 24 h urine volume increased significantly. The ab- dominal circumference in the catheter group significantly reduced compared with that in the control group, the flow and frequency of ascites drainage significantly increased, and the disease duration was shorter. The catheter group had no special complications. Conclusion CVC abdominal in- dwelling drainage on severe OHSS complicated with tension ascites has good efficacy, and is conve- nient, safe, economical with good compliance. It＇s worthy of wide application.