自发性卵巢过度刺激综合征1例病例报告并文献复习

Spontaneous Ovarian Hyperstimulation Syndrome—— A Report of 1 Case and Literature Review

目的：分析总结1989～2013年国内、外公开发表以及我院收治自发性卵巢过度刺激综合征（sOHSS）患者的临床资料及诊疗特点。方法：分别以“自发性卵巢过度刺激”和“spontaneous ovarian hyperstimulation syndrome”为检索词，检索1989～2013年期间公开发表文献，并结合我院诊治的1例患者进行文献复习并综述。结果：sOHSS多发生于妊娠早、中时期，以孕6-16周发病率最高，中位数孕周为10周；病史中无药物诱发促排卵史，临床症状主要表现为腹痛腹胀、恶心呕吐、胸腹水、全身水肿，血液生化检查提示血液浓缩、血清离子紊乱、血清激素水平不同程度上升：超声表现为双侧卵巢呈多囊性外凸性增大；治疗方式以缓解症状为主的对症治疗为原则。结论：应提高对sOHSS的认识，并注意与妊娠合并卵巢肿瘤相鉴别，早期诊断后尽早实施以预防及对症为主的综合治疗策略，避免过度治疗。

Objective： To analyze and summarize the clinical data and diagnostic and treatment characteristics of patients with spontaneous ovarian hyperstimulation syndrome （sOHSS） hospitalized in our hospital and reported in the world from 1989 to 2013. Methods： The literature reports published from 1989 to 2013 were searched as the key words ＂spontaneous ovarian hyperstimulation syndrome＂. Then the literature review was conducted based on the cases published and one case hospitalized in our hospital. Results： sOHSS occurred most frequently during the early and middle pregnancy, with the incidence reaching the highest from week 6 to 16. The median gestational week was 10 weeks. No drug-induced ovulation history was presented and the clinical manifestations included abdominal pain and distension, nausea and vomiting, pleural effusion and ascites, and anasarca. The biochemical blood testing indicated hemoconcentration, serum ion disorder, and increase in serum hormone level. The ultrasound examination indicted polycystic enlargement and convexity of the bilateral ovaries. The treatment strategies were mainly syndrome alleviation and symptomatic treatment. Conclusion： The importance of sOHSS should be highlighted, and it should be distinguished from ovarian tumor in pregnancy. Preventive and symptomatic treatment should be applied after the early diagnosis to avoid overtreatment.