| 向 睿,杨智玲,叶礼翠,张珊珊,王静依.输卵管妊娠患者术后重复性异位妊娠情况及其影响因素分析[J].,2020,(8):1536-1539 |
| 输卵管妊娠患者术后重复性异位妊娠情况及其影响因素分析 |
| Postoperative Repetitive Ectopic Pregnancy in Patients with Salpingocyesis and Its Influencing Factors |
| 投稿时间：2019-11-28 修订日期：2019-12-23 |
| DOI：10.13241/j.cnki.pmb.2020.08.030 |
| 中文关键词: 输卵管妊娠 重复性异位妊娠 生育能力 影响因素 |
| 英文关键词: Salpingocyesis Repetitive ectopic pregnancy Fertility Influencing factors |
| 基金项目:四川省卫生健康委科研项目（19PJ211） |
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| 中文摘要: |
| 摘要 目的：总结输卵管妊娠患者术后重复性异位妊娠情况，并分析其影响因素。方法：选取2015年1月至2017年1月于我院行输卵管妊娠手术的86例患者作为研究对象，回顾性分析所有患者的临床及随访资料，记录并总结所有患者年龄、孕次、产次、月经史、不孕史、血人绒毛膜促性腺激素（HCG）水平、妊娠部位、手术情况、避孕方式以及疾病史等和术后重复性异位妊娠发生情况，并比较不同特征患者术后重复性异位妊娠的发生率，分析影响输卵管妊娠患者术后重复性异位妊娠情况的影响因素。结果：至随访结束，86例输卵管妊娠手术患者术后出现重复性异位妊娠者22例，发生率为25.58%；年龄越大、孕、产次越多、HCG水平越高、存在不孕史、异位妊娠史、输卵管手术史、盆腔感染史以及开腹手术、双侧输卵管粘连及闭锁和长期放置宫内节育器进行避孕的患者其输卵管妊娠术后重复性异位妊娠发生率均明显较高（P<0.05）；经多因素Logistic回归模型分析可得存在不孕史、盆腔感染史、异位妊娠史、输卵管手术史、输卵管双侧粘连及闭锁以及开腹手术是输卵管妊娠手术患者术后重复性异位妊娠发生的独立危险因素（P<0.05）。结论：输卵管妊娠患者术后重复性异位妊娠不可忽视，而对于存在不孕史、盆腔感染史、异位妊娠史、输卵管手术史、输卵管双侧粘连及闭锁以及开腹手术的输卵管妊娠手术患者则应及时治疗不孕症，尽可能选择腹腔镜手术来降低患者术后重复性异位妊娠，以此提高患者术后生育能力。 |
| 英文摘要: |
| ABSTRACT Objective: To summarize the postoperative repetitive ectopic pregnancy in patients with salpingocyesis and analyze its influencing factors. Methods: 86 patients who underwent surgery of salpingocyesis in our hospital from January 2015 to January 2017 were selected as the research objects. The clinical and follow-up data of all patients were retrospectively analyzed. All patients' age, gravidity, parity, menstrual history, infertility history, blood human chorionic gonadotropin (HCG) levels, pregnancy location, surgical status, contraceptive methods, disease history, and incidence of postoperative repetitive ectopic pregnancy were recorded and summarized, and the incidence of postoperative recurrent ectopic pregnancy in patients with different characteristics was compared. The influencing factors of postoperative repetitive ectopic pregnancy in patients with salpingocyesis were analyzed. Results: After the follow-up, in 86 patients with salpingocyesis, there were 22 patients with postoperative repetitive ectopic pregnancy, the incidence was 25.58%. The incidence of postoperative repetitive ectopic pregnancy after surgery of salpingocyesis in patients who had older age, many gravidity and parity, higher HCG levels, infertility history, ectopic pregnancy history, tubal surgery history, pelvic infection history and laparotomy surgery, bilateral tubal adhesions and atresia, and long-term placement of intrauterine device was significantly higher(P <0.05). Multivariate logistic regression analysis showed that infertility history, pelvic infection history, ectopic pregnancy history, tubal surgery history, bilateral tubal adhesions and atresia and laparotomy surgery were independent risk factor for postoperative repetitive ectopic pregnancy after surgery of salpingocyesis(P<0.05). Conclusion: The postoperative repetitive ectopic pregnancy after surgery of salpingocyesis should not be ignored, and patients with surgery of salpingocyesis who have infertility history, pelvic infection history, ectopic pregnancy history, tubal surgery history, laparotomy surgery and bilateral tubal adhesions and atresia should be treated in time. Whenever possible, laparoscopic surgery is selected to reduce postoperative repetitive ectopic pregnancy in order to improve fertility of patients. |
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