卵巢过度刺激综合征病人的系统护理

[目的]总结卵巢过度刺激综合征病人的系统护理。[方法]回顾性分析在接受体外受精-胚胎移植治疗的病人中20例因促排卵并发卵巢过度刺激综合征病人的临床资料及护理,护理重点应包括心理护理、饮食及用药护理、腹胀及腹痛的护理、腹腔积液引流的护理及出院后指导等。[结果]20例病人经积极治疗及护理后均康复。[结论]加强卵巢过度刺激综合征病人的系统护理有利于预后。     

综合护理干预在重度卵巢过度刺激综合征病人中的应用

[目的]探讨综合护理干预在重度卵巢过度刺激综合征病人中的应用效果。[方法]选取应用促性腺激素诱导排卵后发生重度卵巢过度刺激综合征病人80例,根据随机数字表法其分为对照组和观察组,每组40例。对照组采取常规护理,观察组在此基础上实施包括护理风险干预、心理护理干预、用药护理干预、饮食健康教育及出院指导等综合护理干预措施,对两组病人的护理效果进行比较。[结果]对照组病人住院时间、住院费用及护理满意度分别为7.68d±1.77d、6 145.23元±201.29元及90.72分±4.47分;观察组为6.36d±1.64d、5 062.78元±180.31元及94.58分±4.84分。观察组病人住院天数及住院费用低于对照组,护理满意度高于对照组,经比较差异均具有统计学意义(P0.05)。[结论]对重度卵巢过度刺激综合征病人实施综合护理干预可缩短住院时间,减少住院费用,提升护理满意度,有助于促进病人康复。     

16例卵巢过度刺激综合征病人的护理

对16例卵巢过度刺激综合征病人实施全面的护理,包括心理护理、输液护理、胸腹腔积液护理、感染护理及出院指导,结果16例卵巢过度刺激综合征病人均痊愈出院,无流产发生.     

优质护理服务在卵巢过度刺激综合征病人中的应用

[目的]探究优质护理对于缓解卵巢过度刺激综合征病人病情的效果。[方法]对210例病人采用一般护理、心理护理、饮食护理、健康教育、加强护士培训在内的优质护理服务,并在治疗2个月后对210例病人进行问卷调查。[结果]病人在情绪、症状等方面均有不同程度的改善,生活质量有所提高;87.13%的病人感到非常满意,11.72%的病人感到满意。[结论]对卵巢过度刺激综合征病人采用优质护理可提高病人生活质量,对治疗有积极作用。     

超促排卵并发中、重度卵巢过度刺激综合征的护理

目的探讨超促排卵治疗过程中并发中、重度卵巢过度刺激综合征(ovarian hyper-stimulation syndrome,OHSS)的护理对策。方法回顾性总结2010年6月至2011年6月在接受体外受精-胚胎移植治疗的患者中,80例因超促排卵并发中、重度卵巢过度刺激综合征患者的临床资料及护理体会。结果 80例患者经积极治疗及护理后,均全部康复,其中32例获得妊娠、48例终止妊娠。结论中、重度卵巢过度刺激综合征患者的护理重点应包括预防性监测及护理、心理护理、饮食及用药护理、腹胀及腹痛的护理、腹水引流的护理及出院后指导等。     

重度卵巢过度刺激综合征病人情绪障碍的干预研究

[目的]观察重度卵巢过度刺激综合征病人焦虑及抑郁状况及其相关影响因素,探讨心理干预对病人焦虑及抑郁水平的影响。[方法]采用Zung焦虑自评量表（SAs）、Zung抑郁自评量表（SDS）、汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HAMD）在心理干预前后分别对46例重度卵巢过度刺激综合征病人进行心理状态评定。[结果]病人均存在不同程度的焦虑及抑郁情绪。心理干预前后病人的焦虑及抑郁水平比较,差异有统计学意义（P〈O．01）。病人焦虑及抑郁水平与年龄及做体外受精一胚胎移植（IVF—ET）的次数密切相关,与文化程度无明显相关性。[结论]心理干预能有效降低重度卵巢过度刺激综合征病人焦虑及抑郁水平。     

重度卵巢过度刺激综合征的护理

总结8例重度卵巢过度刺激综合征患者的临床护理方法。包括加强心理护理和病情观察,然后从体位、饮食、预防感染、出院宣教等4个方面进行一般护理和对症护理。经有效的治疗和护理,8例患者均痊愈出院。认为通过对重度卵巢过度刺激综合征患者进行严密的观察,给予精心护理,可以减轻其症状,促进其康复,且康复后无需终止妊娠,在卵巢过度刺激综合征患者的转归中起着重要作用。     

临床护理路径对卵巢过度刺激综合征病人心理健康的影响

[目的]探讨临床护理路径对卵巢过度刺激综合征病人心理健康状况的影响。[方法]将研究对象随机分为干预组和对照组各20例,分别采取常规护理和临床护理路径护理,采用症状自评量表(SCL-90)对病人进行心理测试。[结果]干预组和对照组出院时在躯体化、强迫、抑郁、焦虑、敌对、恐怖方面的得分差异均有统计学意义(P<0.05)。[结论]临床护理路径干预有助于提高卵巢过度刺激综合征病人的心理健康水平。     

重度卵巢过度刺激综合征病人情绪障碍的干预研究

[目的]观察重度卵巢过度刺激综合征病人焦虑及抑郁状况及其相关影响因素,探讨心理干预对病人焦虑及抑郁水平的影响.[方法]采用Zung焦虑自评量表(SAS)、Zung抑郁自评量表(SDS)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)在心理干预前后分别对46例重度卵巢过度刺激综合征病人进行心理状态评定.[结果]病人均存在不同程度的焦虑及抑郁情绪.心理干预前后病人的焦虑及抑郁水平比较,差异有统计学意义(P＜0.01).病人焦虑及抑郁水平与年龄及做体外受精-胚胎移植(IVF-ET)的次数密切相关,与文化程度无明显相关性.[结论]心理干预能有效降低重度卵巢过度刺激综合征病人焦虑及抑郁水平.     

体外受精-胚胎移植术后重度卵巢过度刺激综合征患者的护理体会

目的:总结体外受精-胚胎移植术后重度卵巢过度刺激综合征患者的护理措施。方法:对2005年1月～2011年12月在我科住院治疗的94例体外受精-胚胎移植术后重度卵巢过度刺激综合征患者的护理方法进行回顾性分析。结果:94例体外受精-胚胎移植术后重度卵巢过度刺激综合征患者经过精心的护理后均康复出院。结论:严密监测病情,精心的基础护理及心理护理,加强生活护理及出院指导等是配合重度卵巢过度刺激综合征治疗的主要护理措施。     

Association of ovarian response with picoAMH in women undergoing controlled ovarian hyperstimulation

ObjectiveOur study aims to evaluate the diagnostic performance of a high-sensitivity picoAnti-Müllerian Hormone (picoAMH) for predicting ovarian response in women undergoing controlled ovarian hyperstimulation and occurrence of ovarian hyperstimulation syndrome.MethodsRetrospective cohort study at a single academic fertility center including all patients with picoAMH ELISA who underwent controlled ovarian hyperstimulation. The primary outcome was the number of oocytes retrieved, and secondary outcomes included cycle cancellation and ovarian hyperstimulation syndrome. Patients were grouped into poor, normal, and hyper-responders based on number of oocytes retrieved.ResultsThe mean AMH and antral follicle count (AFC) were significantly different between normal response vs. hyper response group (p < 0.0001). Only serum AMH and not AFC was significantly increased in patients diagnosed with ovarian hyperstimulation syndrome (OHSS). For prediction of OHSS, receiver operating characteristic (ROC) analysis revealed that AMH (area under the ROC curve [AUC] = 0.85) was significantly better than the AFC (AUC = 0.64). The serum AMH cut-off at sensitivity of 80% for predicting OHSS among hyper responders from ROC curve was 3.67 ng/ml. Serum AMH measured by picoAMH ELISA showed superior correlation to number of oocytes retrieved when compared to AFC in the age group over 40 years old (r² = 0.74 and r² = 0.4, respectively)ConclusionThis study shows great utility of picoAMH ELISA for predicting ovarian response to controlled ovarian hyperstimulation (COH). Diagnostic performance of picoAMH for prediction of OHSS is superior to the AFC in our cohort.     

卵巢癌合并卵巢脓肿一例

卵巢癌是常见的妇科恶性肿瘤,其早期病变因症状及体征不明显且起病隐匿,故缺乏有效的筛查手段。卵巢癌合并卵巢脓肿或者卵巢脓肿恶变为卵巢癌在临床上发病率极低,确诊需要依赖临床实验室、病理及免疫组织化学等相关检查,治疗以手术为主,辅以化学治疗联合或不联合靶向治疗,临床疗效欠佳。该文结合病历资料及相关文献进行回顾性分析,对1例卵巢腺癌合并卵巢脓肿的临床特点及其诊治方法进行总结报道,以期引起临床医师的重视,提高对这类疾病的认识,为该类疾病的诊断和治疗提供支持。     

腹腔镜卵巢打孔联合药物治疗难治性 多囊卵巢综合征临床分析

目的探讨腹腔镜卵巢打孔术(LOD)结合来曲唑(LE)对难治性多囊卵巢综合征(PCOS)不孕的治疗效果。方法将72例患者随机分成研究组和对照组各36例,所有患者进行LOD。手术前后分别测血黄体生成激素(LH)、卵泡刺激素(FSH)、睾酮(T)及雌二醇(E2)水平,术后第9天起监测患者卵泡发育和排卵共3个周期,并记录妊娠数和流产数。结果两组患者术后LH和T水平与术前相比均有显著性下降(P<0.05),两组E2水平术后均较术前降低,但研究组治疗后降低更为显著(P<0.05)。3个治疗周期内研究组排卵率明显高于对照组(P<0.05)。结论 LOD后结合氯米芬(CC)能明显改善难治性PCOS患者的排卵和受孕机会。     

Two cases of pregnant women with ovarian endometrioma mimicking a malignant ovarian tumor

The detection of an ovarian mass during pregnancy is often a diagnostic challenge. We describe 2 cases of ovarian endometrioma during pregnancy with marked mural nodules on the cyst wall. The sonographic and MR imaging findings mimicked ovarian cancer. Surgical intervention may still be inevitable to exclude the possibility of malignancy.     

腹腔镜卵巢电凝术治疗难治性多囊卵巢综合征的效果

目的 评价腹腔镜下卵巢电凝术治疗难治性多囊卵巢综合征(PCOs)的效果.方法 应用电视腹腔镜对65例促排卵方案治疗无效的PCOS患者行卵巢电凝术,观察患者的月经情况、排卵和受孕情况,比较术后血清促卵泡生成素(FSH)、黄体生成素(LH)、睾酮(T)、雌二醇(E2)水平的变化.结果 术后LH 、T水平较术前明显降低(P＜0.05);随访2年,月经情况明显改善;该术式治疗PCOS的自然恢复排卵率为92.31％,术后2年累积受孕率为67.7％,无并发症发生.结论 腹腔镜治疗PCOS简单易行、创伤小、恢复快,为难治性PCOS患者提供了新的治疗途径.     

The contribution of sonographic evaluation of ovarian size in patients with polycystic ovarian disease

The ovarian size of 44 patients with clinical and endocrinologic findings suggesting polycystic ovarian disease (PCOD) was studied by ultrasound examination. Reproducibility of the ovarian parameters (transverse, longitudinal, and anteroposterior diameters, and volume) was also evaluated. The endocrine status of each patient was evaluated by assay of blood levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, 17 beta-estradiol (17 beta E2), and serum prolactin (PRL). Ovarian size was also investigated in 40 women with normal cycles, following the same ultrasound procedure. The mean ovarian volume of the normal controls was statistically different from the mean of patients with PCOD. Only 34 per cent of the patients affected by PCOD were above the second standard deviation of normal ovarian size. A correlation between endocrinologic findings and ovarian size was observed in women whose ovarian size fell within normal limits; these women had higher, though not statistically different, values of LH and testosterone and lower values of 17 beta E2 and PRL compared with patients with enlarged ovaries. Responsiveness to treatment was more easily observed in patients with ovarian enlargement.     

The immunotherapy of patients with ovarian cancer

Ovarian cancer is a leading cause of cancer mortality. Chemotherapy is effective in reducing tumor burden in a majority of patients, however, only approximately 20% of advanced disease patients will ultimately survive tumor free, and further treatment options are needed. Continuing advances in immunology make immunotherapy a promising area for future research. The design of immunotherapy strategies for ovarian cancer requires an understanding of the immune microenvironment of the peritoneal cavity, which is frequently involved with ovarian cancer metastases and is the site of its most devastating effects. Immunotherapy approaches for ovarian cancer include locoregional and systemic cytokine therapies, prophylactic and therapeutic vaccines, and adoptive immunotherapy strategies. This review will summarize previous clinical trials as well as future directions for research. Further progress in T-cell specific immune responses will require the identification of specific ovarian cancer antigens that are processed and presented on the surface of tumor cells in the context of specific HLA molecules. In addition, a more detailed understanding of functional relations between the peritoneal microenvironment and the metastatic process is required.     

Fertility-sparing treatment of patients with ovarian cancer

Ovarian malignancies in reproductive age women often provide the physician and patient with a management dilemma. Many investigators have proposed conservative management in early-stage disease. This article provides evidence supporting fertility-sparing management in young women with early ovarian malignancies.