双循环双通道方案对合并妊娠的重度卵巢过度刺激综合征的治疗效果

发布时间：2019-04-29 13:20

【摘要】：目的分析比较不同治疗方案在合并妊娠的重度卵巢过度刺激综合征(OHSS)中的治疗效果,以探讨双循环双通道方案对合并妊娠的重度OHSS的治疗优势。方法收集60例经体外受精-胚胎移植(IVF-ET)成功妊娠的重度OHSS患者作为研究对象。回顾性分析其治疗方案,分为常规单循环治疗组(A组),双循环双通道治疗组(B组)。分别比较其治疗前、治疗后第3d、治疗后第9d两组患者的体质量(BM)、腹围(AC)、B超下的腹水最大深度(D)、血清白蛋白(ALB)、Na+浓度、白细胞计数(WBC)、红细胞压积(HCT)、尿量以及饮入量的变化;并比较两组的住院天数、住院费用、腹穿次数、总的白蛋白用量和妊娠结局。结果 1两组对象在入院时各指标差异均无统计学意义。2治疗后第3dBM、HCT较治疗前的变化值两组间差异无统计学意义;治疗后第9d仅HCT B组下降较A组更明显(P0.05)。3治疗后第3d,AC、WBC均较治疗前降低,B组减少更明显(P0.05),A组D变化不明显,有部分患者甚至增加,B组则较治疗前降低(P0.05);治疗后第9d,AC、D、WBC均较治疗前降低,B组减少更明显(P0.05);两组尿量、饮入量均较治疗前增加,B组增加更明显(P0.05)。4治疗后第3d,ALB较治疗前降低,B组下降少于A组(P0.05);治疗后第9d,两组患者ALB均较治疗前升高,B组升高更明显(P0.05)。5B组的住院时间、住院费用均少于A组(P0.05),A组输注白蛋白的量和腹穿次数多于B组(P0.05)。6B组患者均成功妊娠,A组有1例患者治疗效果差,终止妊娠。结论采用双循环双通道的治疗方案,能有效纠正OHSS患者的"三低一高"(低蛋白血症、低渗透压、低血容量及高血凝状态)的病理状态,减少患者的住院时间及费用。
[Abstract]:Objective to analyze and compare the therapeutic effects of different treatment regimens on severe ovarian hyperstimulation syndrome (OHSS) complicated with pregnancy, and to explore the advantages of dual circulation and dual channel regimen in the treatment of severe OHSS complicated with pregnancy. Methods 60 patients with severe OHSS who were successfully pregnant by in vitro fertilization-embryo transfer (IVF-ET) were selected as subjects. The therapeutic regimen was retrospectively analyzed and divided into routine single circulation treatment group (A group) and double circulation and double channel treatment group (B group). Before treatment, 3 days after treatment, and 9 days after treatment, the maximum serum albumin (ALB), Na concentration and white blood cell count (WBC), of ascites with (BM), abdominal circumference (AC), ultrasound in the two groups were compared with those before treatment, 3 days after treatment and 9 days after treatment respectively. Changes in urine volume and intake of hematocrit (HCT),; The hospitalization days, hospital expenses, abdominal puncture times, total albumin dosage and pregnancy outcome were compared between the two groups. Results (1) there was no significant difference in each index between the two groups on admission. (2) there was no significant difference between the two groups in the changes of BM and HCT on the 3rd day after treatment compared with those before treatment. On the 9th day after treatment, the decrease of AC,WBC in HCT group B was more obvious than that in group A (P0.05). 3 on the 3rd day after treatment, AC,WBC decreased more significantly in group B than that before treatment (P 0.05), A group, D change was not obvious, and some patients even increased, P 0.05, P < 0.05). Group B was lower than that before treatment (P0.05). On the 9th day after treatment, AC,D,WBC was lower than that before treatment, and the decrease was more obvious in group B (P0.05). The urine volume and drinking volume in both groups were higher than those before treatment, and the increase in group B was more obvious than that before treatment (P0.05). 4 on the 3rd day after treatment, ALB was lower in group B than that before treatment, and the decrease in group B was less than that in group A (P0.05). On the 9th day after treatment, the ALB of both groups was higher than that of pre-treatment, and the increase of group B was more obvious (P0.05). 5the length of hospitalization and the cost of hospitalization in group B were lower than those in group A (P0.05). The amount of albumin infusion and the times of abdominal puncture in group A were higher than those in group B (P0.05). All the patients in group 6B were pregnant successfully, and one patient in group A had poor therapeutic effect to terminate pregnancy. Conclusion double circulation and double channel therapy can effectively correct the pathological status of OHSS patients (hypoproteinemia, low osmolarity, hypovolemia and hypercoagulability), and reduce the length of stay and the cost of hospitalization of the patients. [WT5 "HZ] conclusion\?
【作者单位】：四川大学华西第二医院生殖内分泌科;
【分类号】：R714.8

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