77例卵巢过度刺激综合征临床分析
Clinical analysis of 77 cases with ovarian hyperstimulation syndrome

目的 ·探讨卵巢过度刺激综征(OHSS)的发病高危因素及治疗经验。方法 ·回顾分析2010年1月至2016年12月上海交通大学医学院附属第九人民医院收治的77例中度和重度OHSS患者的临床资料。结果 · OHSS合并妊娠者较未妊娠者更易发展为重度OHSS，病情更严重(P<0.05)。在促排卵并取卵后进行胚胎移植的患者较未行胚胎移植的患者更容易发生重度OHSS(P<0.05)，住院时间更长(P<0.05)。重度OHSS患者是否抽放胸水、腹水对住院时间及低分子右旋糖酐的用量无影响(P>0.05)，穿刺放水者的白蛋白用量更大(P<0.05)。结论 ·对于促排卵、取卵患者，应观察评估其发生OHSS的风险，来决定是否进行鲜胚移植；对于已进行胚胎移植或明确妊娠的OHSS患者更应注意病情的进展情况，给予个体化治疗方案。
： Objective · To discusses the high risk factors and therapy strategies for ovarian hyperstimulation syndrome (OHSS). Methods · Seventy-seven cases with moderate and severe OHSS were collected to be retrospectively analyzed in Shanghai Ninth People’s Hospital affiliated to Shanghai Jiao Tong University School of Medicine from January 2010 to December 2016. Results · Compared with non-pregnant patients, pregnant patients were more likely to have severe OHSS (P<0.05). Embryo transfer patients who underwent ovulation induction and oocyte retrieval became severe OHSS much more easily and had a much longer hospital stay than oocyte retrieval patients (P<0.05). Pumping ascites and pleural effusion or not has no effect on the length of hospital stay and the usage of low molecular dextran for patients with severe OHSS. Conclusion · The risk of OHSS should be evaluated to determine whether or not to carry out a fresh embryo transfer in patients who underwent ovulation induction and oocyte retrieval. For OHSS patients who have undergone embryo transfer or pregnancy, more attention should be paid to the progress of the disease, and individualized treatment is required