Clinical Analysis For 70 Patients Of Moderate And Severe Ovarian Hyperstimulation Syndrome

Objective : To analysis the risk factors of OHSS;Analysis of pregnance ? OHSS occurrence time and medium and severe OHSS correlation;Compare the treatment effectiveness of Hydroxyethyl Starch 130/0.4 and albumin for medium and severe OHSS?Methods : Choosing70 patients in vitro fertilizationembryotransfer(IVF-ET)patients with medium and severe OHSS hospitalized in the first hospital,jilin university between August 2013 and December 2014.To detected the relative influence factors of medium and severe OHSS by Logistic regression analysis.They were devided into medium OHSS and severe OHSS,according to Golan standard;They were devided into early OHSS and late OHSS,according to different disease time;They were devided into OHSS with pregnancy and OHSS with non-pregnancy,according to pregnancy.To analysis correlation between pregnance and medium ? severe OHSS,and to analysis correlation between OHSS occurrence time and medium ? severe OHSS.They were devided into two groups:experimental group of 35 patients with Hydroxyethyl Starch 130/0.4,l 000 ml,ivgtt,5days;control group of 35 patients with Albumin,12.5g,ivgtt,5days.Measure the change of routine blood indicators,liver function indicators and clinical effect before and after after 5 days treatment.Results:1.The comparison of age,BMI,the HCG injection day E2 values and puncture follicle number between medium OHSS group and severe OHSS group have not statistically significant(P>0.05).The Logistic regression analysis results showed that protect factors of OHSS were age and body mass index(OR<1)and the risk factors of OHSS were the HCG injection day E2 values and puncture follicle number(OR>1).2.The correlation between pregnancy and OHSS severity:in this research,there were 11 cases with pregnancies,included medium OHSS 1 cases(9%)and severe OHSS 10cases(91%);there were 59 cases without pregnancy,included medium OHSS 33 cases(56%)and severe OHSS 26cases(54%);both comparison,p=0.004?p<0.05,the difference was statistically significant.3.The correlation between OHSS occurrence time and the degree of OHSS : in this research,there were 54 cases with early OHSS,included medium OHSS 33 cases(61%)and severe OHSS 21cases(39%);there were 16 cases with late OHSS,included medium OHSS1 cases(6%)and severe OHSS 15 cases(94%);both comparison,p=0.0001?p<0.05,the difference was statistically significant.4.Treatment mearsure Hydroxyethyl Starch 130/0.4 and albumin were used to treat all the patients.Dilatation was used for all the patients,1 cases of 34 cases medium OHSS made large volum paracentesis,and 15 cases of 36 cases severe OHSS made large volum paracentesis.5.The comparison between Hydroxyethyl Starch group with Albumin group5.1 Blood routine indicator:comparison between groups:before treatment,there is no statistically significant between white blood cells count and Hct value among 2 groups(p>0.05);after5 days treatment,white blood cells count of Hydroxyethyl Starch group is lower than Albumin group,which has no statistically significant(p > 0.05);Comparison in the group : Hydroxyethyl Starch group : white blood cells count and Hct value of after 5 days treatment is lower than that of before treatment,there is statistically significant(p<0.05).Albumin group:after 5 days treatment,white blood cells count and Hct value are lower than that of before treatment,there is statistically significant(p<0.05).5.2 Liver function indicators : comparison between groups:before treatment,there is no statistically significant on liver function indicators among 2 groups(p>0.05);after5 days treatment,there is no statistically significant between Hydroxyethyl Starch group and Albumin group(p>0.05).Comparison in the group:Hydroxyethyl Starch group:Liver function indicators of after 5 days treatment is no significant change than that of before treatment(p>0.05),Albumin group is as same as Hydroxyethyl Starch group(p>0.05).5.3 Comparison of the clinical efficacy:After 5days treatment,Hydroxyethyl Starch group and Albumin group,respectively,the clinical efficacy was 85.7%and 80%,there is not statistically significant(p>0.05).Conclusion:1.Age,body mass index,HCG injection day E2 values,and piercing follicle number are the related factors of OHSS,and play an important role in indicating OHSS.2.Pregnancy may aggravate OHSS condition.3.Compared with early OHSS patients,the patients with late OHSS had more severe clinical symptoms.4.During the treatment of medium and severe OHSS patients,Hydroxyethyl Starch and Albumin have the same role of expansion effect.Compared with Albumin,the price of Hydroxyethyl Starch is lower than Albumin,and it has almost no significant side effects,so it can be the first choice for the treatment of medium and severe OHSS patients.