改良细导管引流治疗重度卵巢过度刺激综合征合并大量胸腔积液21例临床分析

Improved fine catheter drainage in the treatment of severe ovarian hyperstimulation complicated with massive pleural effusion: An analysis of 21 cases

目的探讨改良细导管引流治疗卵巢过度刺激综合征（OHSS）合并大量胸腔积液的疗效。方法选择2010-01∽2014-10该院收治的21例因不孕症行体外受精-胚胎移植而发生OHSS合并大量胸腔积液的患者,行B超定位后置入该院自制的改良细导管进行持续胸腔积液引流,同时联合扩容和对症治疗。结果术中无胸闷、呼吸困难等不良反应发生,术后无胸膜反应、肺水肿等严重并发症。胸腔置管平均时间为（9.82±3.22）d102周后症状完全缓解,经B超检查积液完全消失。置管前后复查血白细胞、中性粒细胞、血细胞比容、血小板和白蛋白水平及凝血功能比较,差异具有统计学意义（P〈0.01）。结论改良细导管引流胸腔积液是一种安全、简便、快速缓解压迫症状的有效方法,感染、损伤等副反应少,值得临床推广。

Objective To explore the improvement of fine catheter drainage for ovarian hyperstimulation syndrome（ OHSS） leading to a large volume of pleural effusion. Methods Improved self-made fine catheters were used by B ultrasonic positioning continuously drain of pleural effusion,and fluid expansion and symptomatic treatment were formed. Results No adverse reactions and dyspnea were found during the drainage. No serious complications such as pulmonary edema and pleural reaction were found after the operation. The average time for placing chest tubes was（ 9. 82 ± 3. 22） days,the symptoms were completely relieved after 2 weeks＇ treatment. The pleural effusion was found disappearing completely by B ultrasound examination. The white blood cells,neutrophils,hematocrit,platelet and albumin levels and coagulation function were improved after the drainage,with significant differences compared with those before the drainage（ P〈0. 01）. Conclusion Improved fine catheter drainage is a safe and effective method for the treatment of severe ovarin hyperstimulation complicated with massive pleural effusion. It is simple and economical,can rapidly relieve the symptoms of oppression,reduce infections and other side reactions.