卵巢过度刺激综合征并发肠系膜上静脉及门静脉血栓一例

doi:10.12280/gjszjk.20220552

摘要/Abstract

摘要：

卵巢过度刺激综合征（ovarian hyperstimulation syndrome，OHSS）并发肠系膜上静脉血栓形成（superior mesenteric venous thrombosis，SMVT）及门静脉血栓形成（portal vein thrombosis，PVT）是一种罕见的血栓性疾病，合并妊娠者随着体内人绒毛膜促性腺激素的持续升高，病情进一步加重，严重者可出现肠道缺血性出血、感染性休克、流产、早产以及死亡，是体外受精-胚胎移植（in vitro fertilization-embryo transfer，IVF-ET）助孕过程中较严重的并发症之一。该病早期的临床表现及辅助检查缺乏特异性，极易误诊或漏诊而延误治疗。报告1例患者IVF-ET后10 d发现OHSS，移植后61 d确诊SMVT及PVT并发肠梗阻，经多学科会诊，予吸氧、扩容、抗凝、预防感染、纠正电解质紊乱等治疗，效果差，病情急剧恶化，转院后急诊行坏死小肠切除+残余小肠端端吻合术+肠系膜上静脉及门静脉取栓术，病情稳定后出院，孕5个月余因胎死宫内行引产术。

关键词: 卵巢过度刺激综合征, 肠系膜静脉, 门静脉, 血栓形成, 生殖技术, 辅助, 病例报告

Abstract:

The ovarian hyperstimulation syndrome (OHSS) complicated with superior mesenteric venous thrombosis (SMVT) and portal vein thrombosis (PVT) is a rare thrombotic disease, with the continuous increase of human chorionic gonadotropin in pregnant women and the further aggravated condition. In severe cases, intestinal ischemic hemorrhage, septic shock, abortion, premature delivery and death may occur. Therefore, it is one of the serious complications in the process of in vitro fertilization-embryo transfer (IVF-ET). The early clinical manifestations and auxiliary examinations of the disease are lack of specificity, and it is easy to be misdiagnosed or missed, and to delay treatment. A case of OHSS found 10 days after IVF-ET and diagnosed with SMVT and PVT complicated with intestinal obstruction 61 days after transplantation was reported. After multidisciplinary consultation, the comprehensive treatment of oxygen inhalation, expansion of blood volume, anticoagulation, infection prevention, correction of electrolyte disorders and others was given. The effect was poor and the condition deteriorated sharply. After transferred to our hospital, the emergency resection of necrotic small intestine plus end-to-end anastomosis of residual small intestine plus thrombectomy of superior mesenteric vein and portal vein was performed. At more than 5 months of pregnancy, induction of labor was performed due to fetal death.

Key words: Ovarian hyperstimulation syndrome, Mesenteric veins, Portal vein, Thrombosis, Reproductive techniques, assisted, Case reports

仇梦真, 尚进, 屠晓君, 李洁. 卵巢过度刺激综合征并发肠系膜上静脉及门静脉血栓一例[J]. 国际生殖健康/计划生育杂志, 2023, 42(3): 213-217.

QIU Meng-zhen, SHANG Jin, TU Xiao-jun, LI Jie. Ovarian Hyperstimulation Syndrome Complicated with Superior Mesenteric Venous Thrombosis and Portal Vein Thrombosis: A Case Report[J]. Journal of International Reproductive Health/Family Planning, 2023, 42(3): 213-217.

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