取卵日卵泡大小对体外受精后胚胎早期发育影响的护理研究

Nurse research of the effects of follicle size on early embryonic development of in vitro fertilization-embryo transfer

目的 探讨护理人员取卵日监测卵泡大小对体外受精-胚胎移植（IVF-ET）中卵子成熟及胚胎早期发育的影响.方法 以2012年3月～ 2013年12月来山东省枣庄市妇幼保健院生殖中心行IVF-ET的87个患者为研究对象,研究方法以HCG注射日辅助生殖专职护士进行健康支持教育,取卵日经过专职培训的手术室护士监测观察卵泡直径为依据,对取卵日卵泡大小进行监测、评估、测量液体量,按照卵泡大小将其分大卵泡组、中卵泡组和小卵泡组.取卵手术过程中详细告知实验室人员取出卵泡的大小、取出的液体量.结果 取卵日直径大于15 mm的卵泡获得的卵母细胞成熟度较高（P＜0.01）;（2）大卵泡组卵泡优胚率高于中卵泡组,中卵泡组高于小卵泡组,差异极显著（P＜0.01）.结论 在IVF-ET中,手术室护士通过严密观察、监测卵泡的大小,对实验室人员的详细告知,实验室人员将获得的卵子严格按照大、中、小分类培养,对优质胚胎的获得提供了良好的条件,有利于提高卵子的成熟、受精和早期胚胎发育;有利于提高体外受精-胚胎移植成功率.

Objective： In this study we aimed to investigate the effects of monitoring follicle size by nurses on oocyte maturation and early embryonic development of in vitro fertilization - embryo transfer. Methods： We studied 87 patients ear- fled out IVF - ET in Reproductive Medicine Center of Zaozhuang Maternal and Child Health Hospital from March 2012 to December 2013. Full - time nurses of assisted reproductive conduct health support education on HCG injection day and op- erating room nurses monitor follicular diameter, measure the amount of liquid on the day of oocyte retrieval. All of the folli- cles were classified into three groups （ the group of large size follicles, the group of middle size follicles and the group of small size follicles） according to the diameter size of folliculars. In addition, the nurse informed laboratory personnel about the size of follicles and the amount of liquid during oocyte retrieval. Resuhs ： （1）The ooeytes coming from follicles larger than 15ram mature better （ P 〈 O. 01 ）. （2）High qualified embryo rate was higher in large size follicles group than the middle size group and the middle size group was higher than the small size follicles group （P 〈 0.01 ）. Conclusion： In IVF- ET, the monitoring the size of follicles and fully informed the laboratory personnel by the operating room nurse and classify eul-tured oocytes according to the follicle size by laboratory personnel provide good conditions for the obtain of high quality em- bryos. This is helpful to improve oocyte maturation, fertilization, early embryo development and the success rate of in vitro fertilization - embryo transfer.