新型取卵针对患者在单个卵母细胞获取过程中疼痛和出血的影响
发布时间:2020-12-21 19:07:37
   取卵是辅助生殖的一个重要环节,取卵前先使用药物刺激患者卵巢,利用超声监测卵泡发育至成熟。经阴道超声仪引导,通过取卵针经阴道取卵。由于阴道内超声波吸入术是一种小手术,有些医生为了让患者节约费用只使用止痛药而不使用麻醉。一般取卵时间在30分钟内,患者取卵后有轻微的疼痛和少量的出血。为了评估不同的取卵针对患者取卵的疼痛和出血的影响,做了如下研究:



The Effect of a Newly Designed Needle on the Pain and Bleeding of Patients During Oocyte Retrieval of a Single Follicle
Koji Nakagawa 1*, Yayoi Nishi 1, Masayo Kaneyama 1,Rie Sugiyama 2, Hiroshi Motoyama 2,Rikikazu Sugiyama 1

1- Division of Reproductive Medicine, Sugiyama Clinic, Tokyo, Japan
2- Center for Reproductive Medicine and Endoscopy, Sugiyama Clinic Marunouchi,Tokyo, Japan

Background: The purpose of this study was to evaluate the effect of needle type on pain and bleeding during oocyte pick-up (OPU).

Methods: From May through November 2013, patients undergoing OPU from a single follicle without any analgesic treatment were including this study. Eligible patients (n=75) were randomized1:1 to undergo the procedure with either a reduced needle (17 gauge body, 20 gauge tip; RN group) or a standard needle (19 gauge; SN group). Overall pain was assessed by patients using a visual analogue scale (VAS),and vaginal bleeding after the procedure was recorded. Fisher exact, t-test or Wilcoxon test were used, and p<0.05 was considered to be statistically significant.

Results: The percentage of mature oocytes was 86.5% in the RN group and 91.7% in the SN group. Pain during OPU was significantly lower in the RN group than in the SN group(mean VAS score±SD: 3.2±2.0 cm vs. 4.9±2.2 cm, p<0.01; mean±SD).The frequency of vaginal bleeding was also significantly lower in the SN group(26.3% vs.48.6%; p<0.05). The frequency of bleeding in the RN group was also significantly lower than that in the SN group (26.3% vs. 48.6%; p<0.05). No significant differences were found between the two groups with regard to fertilization and pregnancy rates.

Conclusion: The newly designed needle significantly reduced pain and vaginal bleeding associated with single-follicle OPU in patients receiving no analgesic treatment, in comparison with a standard needle. The RN had no adverse effect on the quality of retrieved oocytes .

摘要:本研究的目的是评估针头类型对取卵(OPU)期间疼痛和出血的影响。20135月至201311月,研究对象为,接受单卵泡获取且未进行任何镇痛治疗的患者。符合条件的患者(n = 75)按11的比例随机接受新型减径针(17G针身,20G针头;RN组)或标准针(19G针;SN组)进行手术?;颊呤褂檬泳跄D饬勘恚?/span>VAS)评估总体疼痛,并记录手术后的阴道出血情况。采用Fisher精确检验,t检验或Wilcoxon检验,p <0.05被认为具有统计学意义。结果发现RN组成熟卵母细胞百分比为86.5%,SN组为91.7%。RN组的取卵期间疼痛明显低于SN(mean VAS score±SD: 3.2±2.0 cm vs. 4.9±2.2 cm, p<0.01;
mean±SD)。RN组的阴道出血频率显著低于SN组(26.3vs 48.6%;p <0.05),RN组的出血频率也显著低于SN组(26.3vs 48.6%;p <0.05)。两组之间在受精率和妊娠率方面没有发现显著差异。由此得出结论,与标准针头(19G针;SN组)相比,新型取卵针(17G针身,20G针头)在未使用止痛药的患者中显著减少了单卵泡获取过程中的疼痛和阴道出血。新型取卵针(RN组)对获取的卵母细胞的质量没有不利影响。


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