体外受精-胚胎移植患者取卵术后疼痛的影响因素分析  

Analysis of influencing factors of pain in patients after oocyte retrieval of in vitro fertilization-embryo transfer

作　　者：罗桂英[1] 王婕妤 王春艳[1] 宋林林 袁兰兰[1] 曹云霞[1] LUO Gui-ying;WANG Jie-yu;WANG Chun-yan;SONG Lin-lin;YUAN Lan-lan;CAO Yun-xia(Reproductive Medicine Center,Department of Obstetrics and Gynecology,the First Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230022,China)

机构地区：[1]安徽医科大学第一附属医院生殖医学中心,安徽合肥230022

出　　处：《中华全科医学》2021年第8期1269-1272,1321,共5页Chinese Journal of General Practice

基　　金：国家重点研发计划项目(2016YFC1000204);安徽省高校自然科学研究重点项目(KJ2020A0203);安徽省高校人文社科重点项目(SK2020A0146)。

摘　　要：目的探讨经阴道穿刺取卵术后疼痛的影响因素,为临床镇痛干预提供理论依据。方法选取2020年4—7月在安徽医科大学第一附属医院生殖中心行体外受精-胚胎移植阴道穿刺取卵术的患者755例,于扳机日20:00评估其焦虑自评量表和抑郁自评量表得分;采用数字等级评定量表评估患者取卵术后30 min、1 h的疼痛程度并记录术后30 min恶心呕吐等不良反应情况。采用数字等级评定量表电话随访患者术后6、12、24 h的疼痛程度,通过单因素有序多分类logistic回归分析和多因素有序多分类logistic回归分析探讨疼痛影响因素。结果单因素有序多分类logistic回归分析发现,年龄、家庭人均月收入、盐酸哌替啶镇痛、手术时间、获卵数和卵巢总体积是术后疼痛的潜在影响因素(均P<0.05)。多因素有序多分类logistic回归分析发现,获卵数(OR=0.692,95%CI:-0.784~0.048)、卵巢体积(<2 000 mm^(3),OR=0.252,95%CI:-1.846~-0.908;2 000~3 999 mm^(3),OR=0.632,95%CI:-0.803~-0.113)是术后疼痛的影响因素(均P<0.05)。结论获卵数越多(≥20枚)、卵巢体积越大(≥4 000 mm^(3))疼痛可能更强烈。超促排卵时控制卵泡数目和卵巢体积,可能会减轻患者疼痛。Objective To explore the influencing factors of pain after transvaginal aspiration for oocyte retrieval, and to provide theoretical basis for clinical analgesia intervention. Methods A total of 755 patients who underwent in vitro fertilization-embryo transfer vaginal puncture for oocyte retrieval in the Reproduction Center of the First Affiliated Hospital of Anhui Medical University from April to July 2020 were selected. The scores of their self-rating anxiety scale and self-rating depression scale were evaluated at 20:00 on trigger day. The numeric rating scale was used to evaluate the pain degree at 30 minutes and 1 hour after oocyte retrieval, and the adverse reactions such as nausea and vomiting were recorded at 30 minutes after operation. The pain degree at 6, 12 and 24 hours after surgery was followed up by telephone with numeric rating scale. Univariate ordered multiple logistic regression analysis and multivariate ordered multiple logistic regression analysis were used to investigate the influencing factors of pain. Results Univariate ordered multi-classification logistic regression analysis showed that age years, family per capita monthly income, pethidine hydrochloride analgesia, operation time, number of follicles obtained and total ovarian volume were the potential influencing factors of postoperative pain (all P < 0. 05). Multivariate ordered multi-classification logistic regression analysis showed that the number of follicles obtained (OR=0.692, 95% CI: -0.784 to -0.048), ovarian volume ( <2 000 mm^(3), OR = 0.252, 95% CI: -1.846 to - 0. 908;2 000 - 3 999 mm^(3), OR =0. 632, 95% CI: - 0. 803 to - 0. 113) were the influencing factors of postoperative pain (all P < 0. 05 ) . Conclusion The greater the number of follicles obtained ( ≥ 20) and the larger the ovarian volume ( ≥4 000 mm^(3)) , the more intense the pain may be. Controlling the number of follicles and the volume of ovaries during superovulation may reduce pain in patients.

关 键 词：体外受精-胚胎移植 取卵术 疼痛 

分 类 号：R169[医药卫生—公共卫生与预防医学] R321.2