联合多重方法预防卵巢过度刺激综合征的研究(1)
[摘要] 目的 探讨联合多重方法预防体外受精-胚胎移植(IVF-ET)周期中卵巢过度刺激综合征(OHSS)的有效性。 方法 将2016年1月1日～2017年12月31日于武汉大学中南医院(以下简称“我院”)行IVF-ET的OHSS高风险患者120例纳入多重方法预防组，除了选择性冷冻保存胚胎外，辅以黄体期输注葡萄糖酸钙、卡麦角林、白蛋白、促性腺激素释放激素拮抗剂等治疗。同时将2014年1月1日～2015年12月31日于我院行IVF-ET的OHSS高风险患者95例纳入对照组。主要观察指标为OHSS的发生率，次要观察指标是体征症状缓解所需的天数。 结果 对照组与实验组重度OHSS的发生率分别为6.3%(6/95)、0.8%(1/120)，两组比较，差异有统计学意义(P < 0.05)。对照组与实验组中重度OHSS患者体征症状缓解所需的天数分别为(6.8±2.1)、(5.4±1.8)d，两组比较，差异有统计学意义(P < 0.05)。轻度OHSS患者体征症状缓解所需的天数差异无统计学意义(P > 0.05)。 结论 联合多重方法预防OHSS的方法科学有效，为IVF-ET中OHSS的预防提出了有力的指导。
[关键词] 卵巢过度刺激综合征；多重途径；发生率；症状缓解
[中图分类号] R711.75 [文献标识码] A [文章编号] 1673-7210(2018)09(c)-0074-04
[Abstract] Objective To explore the efficacy of combined multiple methods in preventing ovarian hyperstimulation syndrome during the in vitro fertilization-embryo transfer (IVF-ET) cycles. Methods From January 1st， 2016 to December 31st， 2017， a total of 120 OHSS high-risk patients with IVF-ET in Zhongnan Hospital of Wuhan University were included in the multi-method prevention group. In addition to the selective cryopreservation of embryos， calcium gluconate， cabergoline， infusion of albumin， GnRH antagonists and other methods were added in luteal phase. In addition， 95 high-risk OHSS patients who underwent IVF-ET from January 1st， 2014 to December 31st， 2015 were included in the control group. The primary outcome measure was the incidence of OHSS， and the secondary outcome measure was the days needed to relieve symptoms. Results The incidence of severe OHSS in control group and experimental group was 6.3%(6/95) and 0.8% (1/120)， respectively. There was a significant difference between the two groups (P < 0.05). The days required for remission of signs in severe OHSS patients in the control group and experimental group were (6.8±2.1) and (5.4±1.8) d， respectively， and there was a statistically significant difference between the two groups (P < 0.05). However， there was no statistically significant difference in days needed to relieve symptoms of mild OHSS patients (P > 0.05). Conclusion The combination of multiple methods to prevent ovarian hyperstimulation syndrome is scientific and effective， which provides a powerful guide for the prevention of OHSS in IVF-ET.
[Key words] Ovarian hyperstimulation syndrome； Multiple pathways； Incidence； Symptom remission
卵巢過度刺激综合征(ovarian hyperstimulation syndrome，OHSS)是一种医源性潜在致命的并发症，以卵巢增大、血管通透性增加、第三体腔积液及相关的病理生理过程为主要特征[1]。由于对控制性超排卵(COH)的过度反应，体外受精(IVF)诱导排卵周期轻度OHSS发生率为20%～33%，中度OHSS发生率为2%～6%，重度OHSS发生率为0.1%～0.2%，死亡病例罕见，为0.1‰～0.3‰[2]。, 百拇医药(陈宏)
[关键词] 卵巢过度刺激综合征；多重途径；发生率；症状缓解
[中图分类号] R711.75 [文献标识码] A [文章编号] 1673-7210(2018)09(c)-0074-04
[Abstract] Objective To explore the efficacy of combined multiple methods in preventing ovarian hyperstimulation syndrome during the in vitro fertilization-embryo transfer (IVF-ET) cycles. Methods From January 1st， 2016 to December 31st， 2017， a total of 120 OHSS high-risk patients with IVF-ET in Zhongnan Hospital of Wuhan University were included in the multi-method prevention group. In addition to the selective cryopreservation of embryos， calcium gluconate， cabergoline， infusion of albumin， GnRH antagonists and other methods were added in luteal phase. In addition， 95 high-risk OHSS patients who underwent IVF-ET from January 1st， 2014 to December 31st， 2015 were included in the control group. The primary outcome measure was the incidence of OHSS， and the secondary outcome measure was the days needed to relieve symptoms. Results The incidence of severe OHSS in control group and experimental group was 6.3%(6/95) and 0.8% (1/120)， respectively. There was a significant difference between the two groups (P < 0.05). The days required for remission of signs in severe OHSS patients in the control group and experimental group were (6.8±2.1) and (5.4±1.8) d， respectively， and there was a statistically significant difference between the two groups (P < 0.05). However， there was no statistically significant difference in days needed to relieve symptoms of mild OHSS patients (P > 0.05). Conclusion The combination of multiple methods to prevent ovarian hyperstimulation syndrome is scientific and effective， which provides a powerful guide for the prevention of OHSS in IVF-ET.
[Key words] Ovarian hyperstimulation syndrome； Multiple pathways； Incidence； Symptom remission
卵巢過度刺激综合征(ovarian hyperstimulation syndrome，OHSS)是一种医源性潜在致命的并发症，以卵巢增大、血管通透性增加、第三体腔积液及相关的病理生理过程为主要特征[1]。由于对控制性超排卵(COH)的过度反应，体外受精(IVF)诱导排卵周期轻度OHSS发生率为20%～33%，中度OHSS发生率为2%～6%，重度OHSS发生率为0.1%～0.2%，死亡病例罕见，为0.1‰～0.3‰[2]。, 百拇医药(陈宏)