复合妊娠32例手术治疗的临床观察  

Clinical Observation of Assisted Reproduction Intrauterine and Extrauterine Combined Pregnancy Operation in 32 Cases

作　　者：王超群[1] 牛洁[1] 蒋苹 黄蓉霞[1] 陈建[1] 孟丽燕[1] WANG Chaoqun;NIU Jie;JIANG Ping;HUANG Rongxia;CHEN Jian;MENG Liyan(The 2nd Department of Gynecology,Kunming Maternal and Child Health Hospital,Kunming Yunnan 650032,China)

机构地区：[1]昆明市妇幼保健院妇二科,云南昆明650032

出　　处：《昆明医科大学学报》2022年第1期118-122,共5页Journal of Kunming Medical University

基　　金：昆明市卫生科技“十百千工程培养”基金资助项目[2021-sw(后备)-60]。

摘　　要：目的观察行辅助生殖助孕后诊断宫内宫外复合妊娠并采取手术治疗的患者,其宫内妊娠的足月活产率,以及分析在手术治疗过程中影响宫内妊娠足月活产率的相关因素。方法回顾性分析行辅助生殖助孕后诊断宫内宫外复合妊娠并经手术治疗宫外妊娠的患者,收集患者的基本资料及手术资料,并随访所有患者宫内孕的妊娠结局。结果(1)本实验共收集到32例患者,其中术后宫内妊娠足月活产有28例,活产率为:87.5%。宫内妊娠的足月活产率与手术时间、术中盆腔积血量呈明显负相关,其中与手术时间的相关系数r=-0.510,P=0.003(P<0.005);与术中盆腔积血量的相关系数r=-0.494,P=0.005(P<0.05);(2)比较32例患者中针对宫外妊娠包块行手术治疗的手术方式及麻醉方式对宫内妊娠足月活产率差异无统计学差异(P>0.05)。结论对于辅助生殖后宫内宫外复合妊娠需手术处理宫外妊娠的患者,减少手术时间及对有手术指征的患者及时手术能提高术后宫内妊娠的足月活产率。Objective To observe the full term live birth rate of intrauterine pregnancy in patients diagnosed with intrauterine and extrauterine combined pregnancy and treated with surgery after the assisted reproduction,and to analyze the related factors affecting the full term live birth rate of intrauterine pregnancy in the course of treatment.Methods A total of 32 patients diagnosed with intrauterine and extrauterine combined pregnancy after the assisted reproduction and treated with surgery for extrauterine pregnancy were collected and,their case data and surgical data were retrospectively analyzed and the pregnancy outcomes of all patients with intrauterine pregnancy were followed up.Results(1)Among the patients,28 of them had the full term live birth of postoperative intrauterine pregnancy,and the live birth rate was 87.5%.The full term live birth rate of intrauterine pregnancy was negatively correlated with the operation time and intraoperative pelvic blood volume,and the correlation coefficient with the operation time was r=-0.510,P=0.003(P<0.005).Correlation coefficient r=-0.494,P=0.005(P<0.05).(2)There was no statistical difference in the full term live birth rate of intrauterine pregnancy between 32 patients with ectopic pregnancy mass treated by surgical method and anesthesia method(P>0.05).Conclusion For the patients with intrauterine and extrauterine combined pregnancy in the assisted reproduction requiring surgical treatment of extrauterine pregnancy,reducing the operation time and early operation for patients with surgical indications can improve the postoperative intrauterine pregnancy to full term live birth rate.

关 键 词：宫内宫外复合妊娠 辅助生殖 宫内妊娠足月活产率 

分 类 号：R711.7[医药卫生—妇产科学]