Le Gouez A, Naudin B, Grynberg M, Mercier F-J
Département d'anesthésie-réanimation, hôpital Béclère, Assistance publique-Hôpitaux de Paris, Université Paris-Sud, 92141 Clamart, France.
Ann Fr Anesth Reanim. 2011 Apr;30(4):353-62. doi: 10.1016/j.annfar.2010.11.026. Epub 2011 Mar 12.
The ovarian hyperstimulation syndrome (OHSS) is a complication of controlled ovarian hyperstimulation (COH) protocols performed in women undergoing assisted reproductive technologies. This syndrome is characterized by multiple intra-ovarian corpus luteum and constitution of a third space that can lead to a life-threatening situation. Although the pathophysiology remains unclear, vascular endothelial growth factor (VEGF) and other cytokines, secreted under the influence of exogenous gonadotrophins administered for COH, are involved in increasing capillary permeability. The clinical course varies from increased size of the ovaries to anasarca with potentially fatal circulatory dysfunction. Mortality rate, though not accurately quantified, is significant (1/45 000 to 1/500 000) and mostly due to thromboembolic complications. The only effective treatment is prevention, by adapting ovarian stimulation protocols to OHSS risk factors. There are no specific treatments and therapy is mainly symptomatic until the condition resolves spontaneously.
卵巢过度刺激综合征(OHSS)是接受辅助生殖技术的女性在控制性卵巢刺激(COH)方案中出现的一种并发症。该综合征的特征是卵巢内多个黄体形成以及第三间隙的构成,这可能导致危及生命的情况。尽管其病理生理学尚不清楚,但在COH过程中使用的外源性促性腺激素影响下分泌的血管内皮生长因子(VEGF)和其他细胞因子参与了毛细血管通透性的增加。临床过程从卵巢增大到全身水肿不等,可能伴有潜在致命的循环功能障碍。死亡率虽未准确量化,但相当可观(1/45000至1/500000),主要是由于血栓栓塞并发症。唯一有效的治疗方法是预防,即根据OHSS风险因素调整卵巢刺激方案。没有特效治疗方法,在病情自发缓解之前,治疗主要是对症治疗。