摘要
目的探讨复合妊娠手术治疗后宫内妊娠早期流产的高危因素。方法回顾性分析2006年9月至2017年8月期间于我院住院行手术治疗的61例复合妊娠的临床资料,根据妊娠结局分为早期流产组(n=21)和妊娠组(n=40),分析两组患者的临床资料特征,比较两组患者的基本资料、临床检查相关指标及手术情况等,并对其中有统计学意义的指标行Logistic多因素分析。结果61例复合妊娠患者经手术治疗后宫内妊娠早期流产率为34.43%(21/61)。既往异位妊娠史情况、下腹痛比例、阴道出血比例、手术时孕龄、盆腔粘连发生比例、异位妊娠累及肌层、异位妊娠破裂比例、手术时长等比较,差异均无统计学意义(P>0.05);与妊娠组比较,早期流产组患者中年龄>35岁比例(40.00%vs.12.20%)、血β-HCG≤80 000U/L比例(85.00%vs.58.54%)显著升高,宫内妊娠胎心搏动者比例(25.00%vs.90.24%)显著下降(P<0.05)。Logistic多因素分析结果示血β-HCG≤80 000 U/L[OR=4.014,95%CI(1.014-15.886)]是宫内妊娠早期流产的独立危险因素(P<0.05)。结论术前血β-HCG≤80 000U/L是复合妊娠手术治疗后宫内妊娠早期流产的高危因素之一。
Objective ： To explore the risk factors for the early miscarriage of combined intrauterine and extra-uterine pregnancies after surgical treatment.Method ： The clinical data of 61 combined intrauterine and extra-uterine pregnancies after surgical treatment in our hospital from September 2006 to August 2017 were retrospectively analyzed.According to the pregnancy outcome,they were divided into pregnancy group （ n =40） and miscarriage group （ n =21）. The general characteristics,clinical examination indicators and surgical conditions were compared between the two groups,and Logistic multivariate analysis was performed on the statistically significant indicators.Results ： The early miscarriage rate was 34.43%（21/61） in 61 patients.There were no significant differences in the history of ectopic pregnancy,the incidences of lower abdominal pain ＆ vaginal bleeding,the gestational age at the time of surgery,the incidences of pelvic adhesions,ectopic pregnancy involving muscular layer,and ectopic pregnancy rupture,and surgery time （ P 〉0.05）. Compared with pregnancy group,the miscarriage group had higher proportion of patients more than 35 years old （40.00% vs.12.20%） and serum β-HCG≤80 000 U/L （85.00% vs.58.54%）,and lower proportion of visible intrauterine heart beat （25.00% vs.90.24%）,and the difference was significant （ P 〈0.05）.Logistic multivariate analysis of the above three factors showed that serum β-HCG≤80 000 U/L was an independent risk factor for early intrauterine abortion[（ OR =4.014,95% CI （1.014-15.886）] （ P 〈0.05） .Conclusions ： β-HCG≤80 000 U/L level is significant risk factor for early miscarriage of combined pregnancy after surgical treatment.
作者
黄宝友
赵红琴
郑飞云
HUANG Bao-you;ZHAO Hong-qin;ZHENG Fei-yun(Department of Gynecology,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 32500)
出处
《生殖医学杂志》
CAS
2018年第12期1214-1218,共5页
Journal of Reproductive Medicine
