基于床旁即时超声分析胚胎移植前患者饮水量对胚胎移植超声显像的影响  

Effect of water intake before embryo transfer on ultrasound imaging during embryo transfer based on POCUS

作　　者：冒文盈 苏振玉 孙秋菊 傅嘉希 鲁南 MAO Wenying;SU Zhenyu;SUN Qiuju;FU Jiaxi;LU Nan(Clinical Center of Reproductive Medicine,First Affiliated Hospital of Nanjing Medical University,Nanjing 210000,Jiangsu,China)

机构地区：[1]南京医科大学第一附属医院临床生殖医学中心,南京210000

出　　处：《医学研究与战创伤救治》2024年第7期750-754,共5页Journal of Medical Research & Combat Trauma Care

基　　金：江苏省卫生健康委科研项目(M2022056)。

摘　　要：目的基于床旁即时超声(POCUS)技术,探讨在胚胎移植前为获得良好膀胱充盈效果的合适摄入水量;不同饮水量对移植时超声成像、困难移植率,胚胎移植成功率以及子宫内膜蠕动的影响。方法收集2023年9月至2024年2月在江苏省人民医院生殖医学中心进行冷冻胚胎移植周期324例患者。根据随机分组原则,将患者分为饮水量300 mL、500 mL和700mL 3组。移植当日患者晨起至移植饮水前量控制在300 mL以内(包括流质食品),在移植前2 h排空膀胱,记录3组患者移植前膀胱充盈的效果并基于POCUS技术和移植后的三维超声,观察患者饮水量、膀胱充盈效果、移植后子宫内膜蠕动、患者满意度以及妊娠结局之间的关联性。结果基于POCUS分析,饮水量为700 mL的患者有最佳的、且在最短时间内获得良好膀胱充盈成像效果(P<0.05)。患者晨起饮水量、满意度评分、移植困难率、子宫内膜蠕动频率差异无统计学意义(P>0.05)。多因素分析提示,饮水量和膀胱充盈效果与妊娠结局之间无直接关联,仅影响成像效果。结论饮水量与膀胱充盈程度及超声成像清晰度密切相关,对子宫收缩、移植困难率、妊娠结局并无显著影响。为获得更佳的成像效果,建议胚胎移植前2 h饮水700 mL。Objective Based on point-of-care ultrasound(POCUS)technology,this study explores the appropriate water in-take for patients before transplantation,the effects of different drinking volumes on embryo transfer imaging,implantation success rate,and endometrial peristalsis.Methods This study was a prospective randomized study,including 324 patients who underwent frozen embryo transfer cycles at the Clinical Center of Reproductive Medicine of People′s Hospital from September 2023 to February 2024.The patients were divided into three groups with water intakes of 300 mL,500 mL,and 700 mL.Water intake from morning until trans-fer was controlled at 300 mL,and the bladder was emptied 2 hours before transfer.The effectiveness of bladder fullness before transfer in the three groups was recorded.Based on POCUS technology and three-dimensional ultrasound immediately after transfer,the correla-tion of patient water intake,bladder filling effect,post-transfer endometrial peristalsis,patient satisfaction,and pregnancy outcomes was observed and analyzed.Results According to POCUS analysis,patients who drank 700 mL of water achieved the best and quickest bladder fullness imaging effect without causing discomfort(P<0.05).There were no statistically significant differences in the patients′morning water intake,satisfaction scores,rates of difficult transfer,frequency of endometrial peristalsis(P>0.05).Multifactorial analysis suggested that water intake and bladder fullness had no di-rect correlation with pregnancy outcomes,only affecting imaging re-sults.Conclusion The results of this study indicate that water in-take is closely related to the degree of bladder fullness and the clarity of ultrasound imaging.However,it has no significant impact on uter-ine contractions or pregnancy outcomes of embryo transfer.To achieve better imaging results,it is recommended to drink 700 mL of water before embryo transfer.

关 键 词：胚胎移植 饮水 膀胱充盈 超声 妊娠 子宫内膜蠕动 

分 类 号：R714[医药卫生—妇产科学]