输卵管重复异位妊娠危险因素与临床特点病例对照研究  

Risk factors and clinical features for recurrent tubal ectopic pregnancy: a case-control study

作　　者：戴毓欣[1] 朱兰[1] 刘珠凤[1] 郎景和[1] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院妇产科,北京100730

出　　处：《中国实用妇科与产科杂志》2017年第6期585-589,共5页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的探讨输卵管重复异位妊娠(REP)危险因素及临床特点。方法纳入北京协和医院2013年1月至2014年12月共78例REP组患者,并按首次异位妊娠(EP)年龄、婚姻状态、就业状态,以1∶1比例匹配77例同期收治初次治疗输卵管异位妊娠(SEP)患者作为SEP组,比较两组的临床特点,并分析REP的危险因素。结果未生育(OR=2.163,95%CI 1.066~4.386)、既往EP开腹手术史(OR=8.585,95%CI 1.001~73.596)是REP的危险因素。REP与SEP临床表现相似,除了REP组术前超声直径>4cm异位妊娠包块数较SEP组明显减少(P<0.01)。REP组术中发现合并粘连及对侧输卵管病变的发生率明显高于SEP组(P<0.05)。结论积极防治首次异位妊娠、合理避孕、采用腹腔镜手术可预防REP发生。Objective To study the risk factors and clinical features of recurrent tubal ectopie pregnancy （REP）. Methods A retrospective case-control study was performed in 78 REP and 77 single ectopic pregnancy （SEP） patients matched at a ratio of 1 ： l with respect to age of initial EP, marital and employment status between January 2013 to December 2014 from Peking Union Medical College Hospital. Results Nonparous women （OR=2.163, 95% CI 1.066-4.386） and previous laparotorny surgery for initial EP patients （0R=8.585, 95%CI 1.001-73.596）were more likely to suffer REP.Clinical features were similar between REP and SEP, except that REP patients had less adnexal mass 〉 4era on ultrasound（P〈0.01 ）.Surgical findings showed that REP had more pelvic adhesion and contralateral tubal disorders （P〈O.05）. Conclusion Active prevention for primary EP, effective contraceptive methods and laparoscopie surgery are proposed to reduce the risk of REP.

关 键 词：输卵管重复异位妊娠 危险因素 临床特点 

分 类 号：R714[医药卫生—妇产科学]