经阴道穿刺取卵术后并发膀胱损伤的临床分析——附3例报告

Clinical analysis of bladder injury after transvaginal oocyte retrieval: a report of three cases

B超引导下的经阴道穿刺取卵术是体外受精-胚胎移植的常规操作之一,膀胱损伤是取卵术后较为少见的并发症。该文报道了在超声引导下经阴道穿刺取卵术后发生膀胱损伤的3例患者,其均有盆腔粘连病史、子宫内膜异位症病史、多次手术穿刺操作史等高危因素。通过对患者进行严密的病情监测、积极对症处理、膀胱冲洗和充分的心理支持后,3例患者均治愈,无严重并发症的发生。该文提示,医务人员应高度警惕阴道穿刺取卵术后膀胱损伤等少见并发症的发生,尤其是对既往有盆腔粘连病史、子宫内膜异位症病史、多次手术穿刺操作史的高危患者,要告知其膀胱损伤的可能性,并积极实施膀胱损伤的三级预防,如膀胱损伤不可避免地发生后,应积极处理,以改善患者的预后。

B mode ultrasound-guided transvaginal oocyte retrieval is a conventional procedure of in vitro fertilization and embryo transfer. Bladder injury is a rare complication after transvaginal ooeyte retrieval. In this article, we reported three eases of bladder injury after ultrasound-guided transvaginal ooeyte retrieval. All patients had a medical history of pelvic adhesion, endometriosis and multiple surgical punctures, etc. After intimate monitoring, active symptonlatie treatment, bladder irrigation and sufficient psychological support, all three patients were recovered without severe complications. This article hints that clinicians should pay extensive attention to the incidence of bladder injury and alternative rare complications after transvaginal ooeyte retrieval, especially for those with a medical history of pelvic adhesion, endometriosis, multiple surgical punctures and other high-risk factors. Patients should be informed with the possibility of bladder injury and grade III preventions of bladder injury should be implemented. For patients presenting with bladder injury, active and effective measures should be taken to improve the clinical prognosis.