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目的探讨地佐辛联合丙泊酚静脉麻醉下行阴道超声引导下取卵术对体外受精妊娠结局的影响。方法常规体外受精(in vitro fertilization,IVF)或卵胞浆内单精子显微注射术(intracytoplasmic sperm injection,ICSI)不孕女性765例,依据麻醉方式分为观察组234例和对照组531例,观察组于地佐辛联合丙泊酚静脉麻醉下行阴道超声引导下取卵术,对照组肌内注射盐酸哌替啶50mg 10min后行阴道超声引导下取卵术,比较2组获卵数、获卵率、IVF受精率、ICSI受精率、2原核(pronucleus,PN)受精率、2PN卵裂率、优质胚胎率、移植胚胎数、生化妊娠率、临床妊娠率、胚胎着床率、流产率、出生率,记录2组术后疼痛、恶心、呕吐等不良反应发生率。结果观察组优质胚胎率(51.21%)明显高于对照组(46.21%)(P<0.05);观察组获卵数[(14.70±6.96)枚]、获卵率[(67.69±18.60)%]、IVF受精率(81.68%)、ICSI受精率(83.07%)、2PN受精率(65.20%)、2PN卵裂率(98.45%)、移植胚胎数[(2.06±0.32)枚]、生化妊娠率(63.20%)、临床妊娠率(54.40%)、胚胎着床率(34.78%)、流产率(8.82%)、出生率(47.20%)与对照组[(13.63±7.05)枚、(67.84±17.60)%、80.17%、82.88%、65.91%、98.65%、(2.02±0.31)枚、64.62%、58.77%、37.79%、8.95%、52.63%]比较差异均无统计学意义(P>0.05);观察组术后轻微疼痛(2.14%)、明显疼痛(0.85%)及恶心(4.27%)发生率低于对照组(19.77%、3.77%、25.42%)(P<0.05),呕吐发生率(1.28%)与对照组(0.94%)比较差异无统计学意义(P>0.05)。结论地佐辛联合丙泊酚静脉麻醉下行阴道超声引导下取卵术对体外受精不孕患者妊娠结局无明显影响,且不良反应轻。
Objective To investigate the effect of dezocine combined with propofol intravenous anesthesia on vaginal ultrasound-guided ovulation in pregnancy outcome of in vitro fertilization. Methods 765 infertile women with in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) were divided into observation group (234 cases) and control group (531 cases) The observation group was given dezocine combined with propofol intravenously under vaginal ultrasound for ovulation induction. The control group received intraperitoneal injection of pethidine hydrochloride 50 mg for 10 minutes and then vaginally guided for ovulation. The number of oocytes retrieved was compared between the two groups IVF fertilization rate, ICSI fertilization rate, 2 pronucleus (PN) fertilization rate, 2PN cleavage rate, high quality embryo rate, transplanted embryo number, biochemical pregnancy rate, clinical pregnancy rate, embryo implantation rate, abortion rate, Birth rate, recorded two groups of postoperative pain, nausea, vomiting and other adverse reactions. Results The rate of high-quality embryos (51.21%) in observation group was significantly higher than that in control group (46.21%) (P <0.05). The number of oocytes in observation group was (14.70 ± 6.96) , IVF fertilization rate (81.68%), ICSI fertilization rate (83.07%), 2PN fertilization rate (65.20%), 2PN cleavage rate (98.45%), transplanted embryo number (2.06 ± 0.32) , Pregnancy rate (54.40%), embryo implantation rate (34.78%), abortion rate (8.82%) and birth rate (47.20%) were significantly higher than those in the control group [(13.63 ± 7.05) and (67.84 ± 17.60) (P <0.05). The observation group (80.17%, 82.88%, 65.91%, 98.65%, (2.02 ± 0.31) cm, 64.62%, 58.77%, 37.79%, 8.95%, 52.63%] had no significant difference The postoperative pain (2.14%), obvious pain (0.85%) and nausea (4.27%) were lower than those in the control group (19.77%, 3.77%, 25.42% Compared with the control group (0.94%), the difference was not statistically significant (P> 0.05). Conclusion Dezocine combined with propofol intravenous anesthesia under vaginal ultrasound-guided oocyte retrieval has no significant effect on pregnancy outcome in IVF patients with mild adverse reactions.