摘要
目的评估腹腔穿刺置管引流术对中重度卵巢过度刺激综合征(OHSS)伴腹水患者妊娠结局的影响。方法回顾性分析2019年4月至2023年8月西北妇女儿童医院生殖妇科收治的437例胚胎移植后发生中重度OHSS伴腹水患者的临床资料,共437个周期。根据处理方式不同将纳入患者分为置管组(125例,采用腹腔穿刺置管引流术治疗)和对照组(312例,未进行腹腔穿刺)。比较两组患者的基本资料、促排卵情况及妊娠结局;采用Logistic回归分析腹腔留置引流管对活产率的影响。结果两组患者的年龄、多囊卵巢综合征(PCOS)患病率、不孕年限、促性腺激素(Gn)用量、移植胚胎类型等比较均无显著性差异(P>0.05)。置管组扳机日血清雌二醇(E 2)水平及获卵数显著高于对照组(P<0.05)。置管组的置管时间为1~24 d,平均(7.80±3.86)d,未观察到与置管相关的感染、腹内器官损伤等并发症。置管组与对照组的临床妊娠率、流产率、早产率、活产率、单胎及双胎分娩新生儿出生体重、分娩孕周、妊娠期高血压疾病及妊娠期糖尿病发生率等比较均无显著性差异(P>0.05)。Logistic回归分析显示,腹腔留置引流管对活产率的影响无统计学意义[OR=1.352,95%CI(0.735,2.485),P=0.332]。结论腹腔穿刺置管引流术是一种有效治疗中重度OHSS伴腹水的方法,且对该类患者的辅助生殖妊娠结局无明显不良影响。
Objective:To evaluate the effect of abdominal paracentesis and catheter drainage on pregnancy outcomes in patients with moderate to severe ovarian hyperstimulation syndrome(OHSS)accompanied by ascites.Methods:A retrospective analysis was conducted on the clinical data of 437 patients with moderate to severe OHSS and ascites who underwent embryo transfer and were admitted to the reproductive gynecology department of Northwest Women’s and Children’s Hospital from April 2019 to August 2023.The patients were divided into a catheter group(125 cases,who underwent abdominal paracentesis and catheter drainage)and a control group(312 cases,who did not receive the treatment mentioned above).The basic information,ovulation induction status,and pregnancy outcomes were compared between the two groups.Logistic regression analysis was used to evaluate the effect of abdominal indwelling catheters on live birth rates.Results:There were no significant differences in age,polycystic ovary syndrome(PCOS)prevalence,duration of infertility,gonadotropin(Gn)usage,and type of transplanted embryo between the two groups(P>0.05).The serum estradiol(E 2)level and number of retrieved oocytes on the trigger day were significantly higher in the catheter group than those in the control group(P<0.05).The duration of catheter indwelling in the catheter group ranged from 1 to 24 days,with an average of(7.80±3.86)days.No complications related to catheter placement,such as infection or intra-abdominal organ injury,were observed.There were no significant differences in clinical pregnancy rate,miscarriage rate,premature birth rate,live birth rate,birth weight of newborns from singleton and twin deliveries,gestational age at delivery,and incidence of hypertensive disorders of pregnancy and gestational diabetes between the catheter group and the control group(P>0.05).Logistic regression analysis showed that abdominal indweuing catheters had no statistically significant effect on the live birth rate[OR=1.352,95%CI(0.735,2.485),P=0.332].Conclusions:Abdominal paracentesis combined with catheter drainage is effective treatment for moderate to severe OHSS accompanied by ascites and has no significant adverse effects on pregnancy outcomes in such patients.
作者
焦敏洁
段海霞
孙树柳
刘琰
熊莉莉
李小娟
JIAO Min-jie;DUAN Hai-xia;SUN Shu-liu;LIU Yan;XIONG Li-li;LI Xiao-juan(Reproductive Gynecology,Northwest Women’s and Children’s Hospital,Xi’an 710003)
出处
《生殖医学杂志》
2025年第9期1170-1175,共6页
Journal of Reproductive Medicine
基金
陕西省西安市科技局项目[20YXYJ0005(9)]。
关键词
卵巢过度刺激综合征
腹水
腹腔穿刺
置管引流
体外受精-胚胎移植
Ovarian hyperstimulation syndrome
Ascites
Paracentesis
Catheter drainage
In vitro fertilization-embryo transfer
