卵巢过度刺激综合征并发血栓栓塞

发布时间：2018-04-15 17:52

本文选题：血栓栓塞 + 卵巢过度刺激综合征(OHSS)　；参考：《生殖与避孕》2015年09期

【摘要】：在体外受精(in vitro fertililization,IVF)周期中,血栓栓塞是卵巢过度刺激综合征(ovarian hyperstimulation syndrome,OHSS)中最严重的并发症,而促性腺激素是诱发血栓栓塞的最主要原因。易栓症标志分子的作用存在争议。在IVF周期中,血栓的发病率为0.11%,致死率为1/45 000~1/500 000。血栓通常发生在静脉(67%~81%),多为头颈部,动脉血栓(19%~33%)多发于脑部。精确识别OHSS高危患者,对其选择恰当的促排卵方案和促性腺激素剂量,并结合冷冻全部卵子或胚胎后行冻融胚胎移植,将显著降低高危患者血栓栓塞的风险。一旦血栓栓塞被早期确诊,使用抗凝剂肝素进行预防就显得尤为关键。但是,减少卵巢刺激后血栓形成风险的最有效方法是识别OHSS高危患者并及时采取预防措施。本文分析促排卵过程中发生OHSS患者血栓形成的发病机理及临床表现,并为此提出实用的预防和治疗方案。
[Abstract]:In IVF cycle, thromboembolism is the most serious complication in ovarian hyperstimulation syndrome (OVS), and gonadotropin is the main cause of thromboembolism.The role of thrombus markers is controversial.During the IVF cycle, the incidence of thrombosis was 0.11 and the mortality was 1 / 45,000 / 500, 000.Thrombosis usually occurs in the head and neck, mostly in the head and neck, and in the brain.The risk of thromboembolism in OHSS patients will be significantly reduced by accurately identifying the high risk patients with OHSS, selecting the appropriate ovulation promotion protocol and the dosage of gonadotropin, and combining with frozen eggs or post-embryo freeze-thawed embryo transfer, which can significantly reduce the risk of thromboembolism in high risk patients.Once thromboembolism is diagnosed early, prevention with anticoagulant heparin is particularly critical.However, the most effective way to reduce the risk of thrombogenesis after ovarian stimulation is to identify high risk patients with OHSS and take preventive measures in time.This paper analyzes the pathogenesis and clinical manifestation of thrombosis in patients with OHSS during ovulation promotion, and puts forward practical prevention and treatment.
【作者单位】：兰州军区兰州总医院生殖医学中心;
【基金】：兰州军区医药卫生科研项目,项目号为CLZ14JB08
【分类号】：R714.8

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