基于危险因素筛查的延续性院外管理对卵巢过度刺激综合征的预防效果

doi:10.6040/j.issn.1671-7554.0.2025.0477

摘要/Abstract

摘要： 目的探讨基于危险因素筛查的延续性院外管理对卵巢过度刺激综合征(ovarian hyperstimulation syndrome, OHSS)的预防效果。方法采用回顾性-前瞻性混合研究设计。首先通过回顾性队列分析(428例)筛选OHSS独立危险因素,通过logistic回归分析OHSS发生的相关因素,采用受试者工作特征曲线评估危险因素预测效能。随后开展前瞻性试验(试验组79例,对照组74例),试验组采用微信平台动态管理,包括高蛋白饮食指导、症状监测及实时答疑、对照组延续传统模式。通过χ2检验比较住院率、独立样本t检验比较卵巢直径变化(超声测量)、睡眠质量及生活质量评分差异。结果回顾性分析显示,获卵数(截断值11.50枚,AUC=0.825)与扳机日E2值(截断值2 995.50 pg/mL,AUC=0.788)为OHSS独立危险因素(P<0.001)。前瞻性试验中,试验组住院率低于对照组(3.8% vs. 13.5%,P=0.031),试验组睡眠质量评分恶化幅度低于对照组［4.00(2.00,6.00)vs. 0(-1.00, 2.00),P<0.001］,生活质量总分［55.15(47.61,65.63)vs. 70.59(57.35,83.82)］及核心模块评分［54.69(44.53,66.67)vs. 70.83(58.33,85.42)］改善(P<0.001),差异均有统计学意义。两组干预后卵巢直径变化差异无统计学意义(P>0.05)。结论基于危险因素筛查的延续性院外管理有效降低OHSS住院率并减轻患者身心负担。

关键词: 卵巢过度刺激综合征, 危险因素, 延续性院外管理, 住院率, 匹兹堡睡眠质量量表, 生育生活质量问卷

Abstract: Objective To evaluate the efficacy of a risk factor-guided continued out-of-hospital management protocol in preventing ovarian hyperstimulation syndrome(OHSS). Methods A retrospective-prospective hybrid study design was adopted. First, a retrospective cohort analysis(428 cases)was conducted to identify independent risk factors for OHSS. logistic regression analysis was employed to examine contributing factors for OHSS occurrence, with receiver operating characteristic(ROC)curve analysis used to evaluate the predictive efficacy of risk factors. Subsequently, a prospective trial was performed, enrolling 79 patients in the intervention group and 74 in the control group. The intervention group received dynamic management through a WeChat platform including high-protein dietary guidance, symptom monitoring, and real-time consultation, while the control group maintained traditional management. The χ2 test was used to compare hospitalization rates, and the independent samples t-test to analyze differences in ovarian diameter changes(ultrasound-measured), sleep quality, and quality of life scores. Results The retrospective analysis identified the number of retrieved oocytes(cut-off value 11.50, AUC=0.825)and trigger-day E2 levels(cut-off value 2 995.50 pg/mL, AUC=0.788)as independent risk factors for OHSS(P<0.001). In the prospective trial, the intervention group showed significantly lower hospitalization rates(3.8% vs. 13.5%, P=0.031). The experimental group exhibited a significantly lower degree of deterioration in sleep quality scores compared to the control group ［median(IQR): 4.00(2.00,6.00)vs. 0(-1.00,2.00), P<0.001］. Moreover, the experimental group demonstrated statistically significant improvements in both the total quality-of-life scores ［55.15(47.61,65.63)vs. 70.59(57.35,83.82)］ and the core module scores［54.69(44.53,66.67)vs. 70.83(58.33,85.42)］ compared to the control group(both P<0.001). No statistically significant differences were found in post-intervention ovarian diameter changes between groups(P>0.05). Conclusion A continued out-of-hospital management guided by risk factor screening effectively reduces hospitalization rates for OHSS and alleviates the physical and psychological burden on patients.

Key words: Ovarian hyperstimulation syndrome, Risk factor, Continuity of out-of-hospital management, Hospitalization rate, Pittsburgh sleep quality index, Fertility quality of life questionnaire

中图分类号:

R714.8

黄玉真,吕琛,颜磊,李帅帅,张景雪,刘超,王银霞,桑岩岩,房鹛. 基于危险因素筛查的延续性院外管理对卵巢过度刺激综合征的预防效果[J]. 山东大学学报 (医学版), 2026, 64(4): 92-99.

HUANG Yuzhen, LYU Chen, YAN Lei, LI Shuaishuai, ZHANG Jingxue, LIU Chao, WANG Yinxia, SANG Yanyan, FANG Mei. Preventive effects of continued out-of-hospital management based on risk factor screening for ovarian hyperstimulation syndrome[J]. Journal of Shandong University (Health Sciences), 2026, 64(4): 92-99.

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