剖宫产瘢痕部位妊娠98例回顾性研究及影响因素分析  

Retrospective study and influencing factors analysis on 98 cases of cesarean section scar site pregnancy

作　　者：谢雄风 林路[1] 张兰玲[1] 宋倩倩 晋茂生[1] XIE Xiongfeng;LIN Lu;ZHANG Lanling;SONG Qianqian;JIN Maosheng(Department of Obstetrics and Gynecology,the First Affiliated Hospital of Bengbu Medical College,Bengbu,Anhui 233000,China)

机构地区：[1]蚌埠医学院第一附属医院妇产科,安徽蚌埠233000

出　　处：《现代医药卫生》2020年第11期1661-1663,共3页Journal of Modern Medicine & Health

摘　　要：目的探讨剖宫产瘢痕部位妊娠(CSP)的危险和保护因素,为预防其发生提供依据。方法选择2015年1月至2019年1月在该院就诊的98例CSP患者作为病例组,同期瘢痕子宫宫内正常妊娠者265例作为对照组。采用logistic回归单因素和多因素分析研究方法,分析年龄、剖宫产次数、人工流产次数、臀位剖宫产、末次剖宫产时间、子宫缝合方式与CSP之间的关系。结果单因素logistic回归分析结果显示,CSP与剖宫产次数、人工流产次数、臀位剖宫产、末次剖宫产时间、子宫缝合方式等因素存在相关性(P<0.05)。多因素logistic回归分析结果显示,剖宫产次数、人工流产次数、臀位剖宫产的比值比(OR)>1,末次剖宫产时间、子宫缝合方式的OR<1,均与CSP相关(P<0.05)。结论年龄对CSP发生无明显影响,下次受孕距前次剖宫产时间大于2年和采用双层子宫缝合方式可以降低CSP发病率,而人工流产次数、剖宫产次数和臀位剖宫产均是CSP高危因素。Objective To investigate the risk and protective factors of cesarean section scar site pregnancy(CSP),and to provide evidence for prevention of CSP.Methods 98 cases of CSP patients admitted to the hospital from January 2015 to January 2019 were selected as the case group,while 265 cases of normal pregnancy with scar in utero were selected as the control group.Univariate and multivariate logistic regression analysis was used to analyze the relationship between age,cesarean section frequency,induced abortion frequency,breech cesarean section,last cesarean section time,uterine suture mode and CSP.Results Uni-factor logistic regression analysis showed that there was a significant relationship between pregnancy in scar area of cesarean section and the number of cesarean sections,number of induced abortion,breech cesarean section,time of last cesarean section,mode of uterine suture and other factors(P<0.05).The results of multivariate logistic regression analysis showed that the ratio(OR)of the number of cesarean sections,the number of induced abortions and breech cesarean sections were greater tnan 1.The OR of the time of last cesarean section and uterine suture mode were less than 1,which were all correlated with CSP(P<0.05).Conclusion Age has no significant effect on the occurrence of CSP.The incidence of CSP can be reduced by double layer uterine suture and the next pregnancy is more than 2 years from the previous cesarean section.The frequency of cesarean section and gluteal cesarean section are the high risk factors of CSP.

关 键 词：剖宫产术 瘢痕 妊娠 高危因素 LOGISTIC回归 

分 类 号：R246.3[医药卫生—针灸推拿学]