卵巢过度刺激综合征B超引导下经阴道腹水抽吸与腹部腹膜穿刺引流的效果对比

Comparison of transvaginal ascites aspiration and abdominal peritoneal puncture drainage under B-ultrasound guidance in ovarian hyperstimulation syndrome

目的探讨卵巢过度刺激综合征(OHSS)患者B超引导下经阴道腹水抽吸与腹部腹膜穿刺引流的效果。方法选取146例OHSS患者,采用随机数字表法分为对照组与研究组,各73例。对照组采用B超引导下经阴道腹水抽吸治疗,研究组采用腹部腹膜穿刺引流治疗。比较两组24 h尿量、腹围、红细胞比容(HCT)、引流量、引流次数、病情恢复时间、住院时间及并发症发生情况。结果干预前,两组24 h尿量、腹围及HCT比较,差异无统计意义(P>0.05);干预5d后,两组24 h尿量明显多于干预前,腹围小于干预前,HCT水平低于干预前,且研究组24h尿量多于对照组,腹围小于对照组,HCT水平低于对照组,差异有统计学意义(P<0.05)。研究组每次引流量、引流次数均明显少于对照组,病情恢复时间、住院时间均短于对照组,差异有统计学意义(P<0.05).研究组并发症发生率为4.11%,明显低于对照组的13.70%,差异有统计学意义(P<0.05).结论B超弓|导下经阴道腹水抽吸治疗OHSS—次可抽3000 ml,但易引起腹压骤降,且反复穿刺增加风险;而腹部腹膜穿刺引流创伤小、并发症发生率低,能缓解患者临床症状,值得临床推广与应用。

Objective To investigate the effect of transvaginal ascites aspiration and abdominal peritoneal puncture drainage guided by B-ultrasound in patients with OHSS.Methods 146 patients with OHSS were randomly divided into control group and study group with 73 cases in each group.The control group was treated with transvaginal ascites aspiration under B-mode ultrasound,and the study group was treated with abdominal peritoneal puncture and drainage.24 h urine volume,abdominal circumference,erythrocyte volume(HCT),drainage flow,drainage times,recovery time,hospital stay and complications were compared between the two groups.Results Before intervention,there were no significant differences in 24 h urine volume,abdominal circumference and HCT between the two groups(P>0.05).After 5 days of intervention,24 h urine volume in both groups was significantly higher than before intervention,abdominal circumference was smaller than before intervention,and HCT level was lower than before intervention.In addition,24 h urine volume in the research group was higher than that in the control group,abdominal circumference was smaller than that in the control group,and HCT level was lower than that in the control group,with statistical significance(P<0.05).Each drainage flow and times of drainage in the study group were significantly less than those in the control group,and the recovery time and hospitalization time were shorter than those in the control group,with statistical significance(P<0.05).The complication rate in the study group was 4.11%,which was significantly lower than 13.70%in the control group(P<0.05).Conclusion Transvaginal ascites aspiration guided by B-ultrasound can be used to treat OHSS with 3000 ml at one time,but it is easy to cause sudden drop of abdominal pressure,and repeated puncture increases the risk.Abdominal peritoneal puncture and drainage has little trauma and low complication rate,which can relieve the clinical symptoms of patients and is worthy of clinical promotion and application.