卵巢妊娠相关高危因素分析——附79例报道  

Retrospective analysis of related risk factors for ovarian pregnancy in 79 cases

作　　者：郑嘉华[1] 王丽丽[1] 周晓静[2] 马毓梅[3] 郝桂敏[1] 王玮[1] 黄向华[4] Zheng Jiahua;Wang Lili;Zhou Xiaojing;Ma Yumei;Hao Guimin;Wang Wei;Huang Xianghua(Department of Reproduction,,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China;Department of Obstetrics&Gynecology Ultrasound Diagnosis and Treatment,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China;Ma YumeiDepartment of Pathology,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China;Department of Gynecology,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院生殖科,石家庄050000 [2]河北医科大学第二医院妇产超声与诊疗,石家庄050000 [3]河北医科大学第二医院病理科,石家庄050000 [4]河北医科大学第二医院妇科,石家庄050000

出　　处：《中华生殖与避孕杂志》2019年第11期899-903,共5页Chinese Journal of Reproduction and Contraception

摘　　要：目的探讨卵巢妊娠高危因素及辅助生殖技术后卵巢妊娠发生率。方法回顾性分析河北医科大学第二医院2003年1月1日至2018年1月1日期间确诊的79例卵巢妊娠患者的病例资料,并通过3个不同的时间段(2003.01.01—2008.01.01、2008.01.02—2013.01.01、2013.01.02—2018.01.01)观察其发展趋势。并同时收集同期输卵管妊娠患者的病例资料,分析卵巢妊娠的影响因素。结果该研究中15年共诊治异位妊娠6943例,其中卵巢妊娠79例(1.14%)。卵巢妊娠在本研究的15年中无逐年升高趋势,不同时间段(2003.01.01—2008.01.01、2008.01.02—2013.01.01、2013.01.02—2018.01.01)中卵巢妊娠在异位妊娠中的占比亦无上升趋势(1.21%、1.09%、1.14%),且差异无统计学意义;通过辅助生殖技术发生的卵巢妊娠在同阶段卵巢妊娠中的占比有上升趋势(8.33%、9.52%、15.22%),但差异无统计学意义。卵巢妊娠组与同期输卵管妊娠组相比,腹部手术史(OR=0.41,95%CI=0.18~0.95,P=0.04)是卵巢妊娠的高危因素。卵巢妊娠患者血清β-人绒毛膜促性腺激素(hCG)水平高于输卵管妊娠患者(P<0.001)。术前2例(2.53%)诊断为卵巢妊娠,70例(88.61%)患者行经阴道超声时,56例(80.00%)提示盆腔积血。51例(64.56%)卵巢妊娠发生在右侧,28例(35.44%)发生在左侧,左右侧发生率差异有统计学意义(P=0.01)。结论辅助生殖技术与卵巢妊娠之间的关系还需要进一步探索。腹部手术史可能是卵巢妊娠的高危因素,且血清β-hCG水平通常较高。卵巢妊娠多发生于右侧卵巢,可能与左侧卵巢解剖结构相关。卵巢妊娠术前诊率极低,影像学检查对其有重要意义。Objective To find the risk factors,difference between preoperative diagnosis and intraoperative findings and the ratio of ovarian pregnancy(OP)after assisted reproductive technology(ART).Methods In the retrospective cross-sectional study,79 patients with OP in the period of January,2003 to January,2018 at the Second Hospital of Hebei Medical University were included.They were divided into three time segments(2003.01.01-2008.01.01,2008.01.02-2013.01.01 and 2013.01.02-2018.01.01)and the time trend was observed.At the same time,the data of tubal pregnancy(TP)in the same period were collected,and the risk factors were compared with those of OP.Results During the entire study period(2003.01.01-2018.01.01),6943 patients with ectopic pregnancy were diagnosed in the hospital.Of these,79 cases were OP(1.14%).OP appeared to have no increasing trend year by year,as well as in ectopic pregnancy when compared with different time periods(2003.01.01-2008.01.01,2008.01.02-2013.01.01 and 2013.01.02-2018.01.01)(1.21%vs.1.09%vs.1.14%).OP after ART had an increasing trend(8.33%vs.9.52%vs.15.22%)with a significant difference.Compared with TP group,the history of abdominal surgery was a high risk factor for OP(OR=0.41,95%CI=0.18-0.95,P=0.04).The serumβ-human chorionic gonadotropin(hCG)level in OP patients was higher than that in TP patients.Two cases(2.53%)had been diagnosed OP before treatment.Seventy cases(88.61%)underwent vagina ultrasonic,of these,56 cases(80.00%)suggested pelvic hematocele.Fifty-one cases(64.56%)of OP occurred in right ovary,28 cases(35.44%)occurred in left ovary.Conclusion The ratio of OP after ART has an increasing trend in recent years,and ART may be a risk factor of OP.The relationship between ART and OP still needs to be further explored.History of abdominal surgery may be a high risk factor for OP,and OP patients tend to have highβ-hCG levels.OP maybe often occur in the right side of ovarian and may be related to the anatomical structure of the left ovary.The preoperative diagnosis rate was low,imaging ex

关 键 词：高危因素 卵巢妊娠 异位妊娠 辅助生殖技术 

分 类 号：R71[医药卫生—妇产科学]