自体腹水回输在卵巢过度刺激综合征治疗中的应用

Application of Autologous Ascites Reinfusion in Ovarian Hyperstimulation Syndrome

自体腹水回输是在无菌密闭系统中将自身腹水引出体外,通过一定装置将其中水、电解质、尿素氮等中小分子物质滤出,而蛋白质等大分子被保留浓缩,回输至人体内的过程。其作为自身白蛋白重利用的一种方式,已较多应用于治疗肝硬化顽固性腹水和癌性腹水患者。卵巢过度刺激综合征(OHSS)主要发生在行促排卵治疗时,以双侧卵巢增大、高雌激素血症、腹水、电解质失衡和少尿为特征,严重者可以出现肝肾功能衰竭、血管栓塞甚至死亡。腹水是中重度患者的常见症状,由于OHSS腹水中不仅含蛋白质、代谢废物,还含有多种激素及炎性因子,直接回输可能会加重病情,因此自体腹水回输目前在OHSS治疗中应用极少。现就自体腹水回输技术在OHSS治疗中的应用作一综述。

The reinfusion of autologous ascites is the operational process under very sterile as draining ascites from body, filtering out water, electrolyte, urea nitrogen, and so on, concentrating proteins and other macromolecular substances, and then infusing back into body. It has been widely used for treating intractable ascites of cirrhosis and malignant ascites as a way of albumin reuse. Ovarian hyperstimulation syndrome （OHSS）, a symptom occurring mainly in ovulation induction, is characterized by the bilateral ovarian enlargement, high vascular estrogen, ascites, electrolyte imbalance and oliguria. Serious OHSS may be accompanied by hepatic or/and renal failure, thromboembolism, or even death. Ascites is a common symptom of moderate or severe OHSS. Besides proteins and metabolic wastes, there are hormones and inflammatory factors in OHSS ascites, which means that infusing directly OHSS ascites may induce the conditional aggravation. The autologous reinfusion of OHSS ascites is rarely used at present. The application of autologous reinfusion of OHSS ascites was reviewed in this paper.