异位妊娠患者腹腔镜术后妊娠失败的高危因素  

High risk factors for pregnancy failure after laparoscopic surgery in patients with ectopic pregnancy

作　　者：王莎莎 Wang Shasha(Jiaozuo Second People’s Hospital,Jiaozuo 454000,China)

机构地区：[1]焦作市第二人民医院,焦作454000

出　　处：《中国实用医刊》2022年第20期29-32,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨异位妊娠患者腹腔镜术后妊娠失败的高危因素,为干预措施的制定提供依据。方法抽取焦作市第二人民医院2019年8月至2021年5月采用腹腔镜下输卵管切开取胚缝合术治疗的184例异位妊娠患者,术后对患者进行为期1年的跟踪随访,随访期间观察异位妊娠患者腹腔镜术后妊娠情况并分组(妊娠失败组与妊娠成功组),记录患者一般资料,包括年龄、生育次数、异位妊娠史等,分析异位妊娠患者腹腔镜术后妊娠失败的高危因素。结果随访截止至2022年4月,184例异位妊娠患者腹腔镜术后妊娠失败45例,妊娠成功139例;妊娠失败组有异位妊娠史、输卵管粘连者占比高于妊娠成功组,术前人绒毛膜促性腺激素(hCG)水平高于妊娠成功组,电凝止血次数多于妊娠成功组,差异有统计学意义(P<0.05);两组年龄、手术时间、术中出血量等资料比较,差异未见统计学意义(P>0.05)。经Logistic回归分析显示,有异位妊娠史、术前血清hCG水平高、输卵管粘连、电凝止血次数多是异位妊娠患者腹腔镜术后妊娠失败的高危因素(OR=3.283、1.011、4.396、3.000,P均<0.05)。结论异位妊娠患者腹腔镜术后妊娠失败的高危因素为异位妊娠史、术前血清hCG水平高、输卵管粘连、电凝止血次数多,临床应积极防治上述因素,以降低患者妊娠失败的风险。Objective To investigate the high risk factors for pregnancy failure after laparoscopic surgery in patients with ectopic pregnancy,so as to provide basis for the formulation of intervention measures.Methods A total of 184 patients with ectopic pregnancy who received laparoscopic salpingotomy for embryo extraction and suture in Jiaozuo Second People’s Hospital from August 2019 to May 2021 were selected.The patients were followed up for 1 year after operation.During the follow-up period,the pregnancy conditions of patients with ectopic pregnancy after laparoscopic operation were observed,and they were grouped(pregnancy failure group and pregnancy success group).The general data of the patients were recorded,including age,times of birth,history of ectopic pregnancy,to analyze the high-risk factors for pregnancy failure in patients with ectopic pregnancy after laparoscopic surgery.Results Followed up to April 2022,45 of 184 cases of ectopic pregnancy failed in pregnancy after laparoscopic surgery,and 139 cases succeeded in pregnancy;compared with the pregnancy success group,the proportions of patients with ectopic pregnancy history and fallopian tube adhesion in the pregnancy failure group were higher,the level of human chorionic gonadotropin(hCG)before operation was higher,and the times of electrocoagulation hemostasis were more,the difference was statistically significant(P<0.05);there was no significant difference between the two groups in terms of age,operation time and intraoperative bleeding amount(P>0.05).Results of Logistic regression analysis showed that the history of ectopic pregnancy,high preoperative serum hCG level,fallopian tube adhesion and more times of electrocoagulation hemostasis were the high risk factors for pregnancy failure in patients with ectopic pregnancy after laparoscopic surgery(OR=3.283、1.011、4.396、3.000;all P<0.05).Conclusions The high risk factors for pregnancy failure in patients with ectopic pregnancy after laparoscopic surgery include ectopic pregnancy history,high preopera

关 键 词：异位妊娠 腹腔镜下输卵管切开取胚缝合术 妊娠失败 输卵管粘连 

分 类 号：R713.8[医药卫生—妇产科学]