Logistics分析瘢痕妊娠发病危险因素及诊治方案对临床指标、疗效和安全性影响  

Logistics analysis of the risk factors of scar pregnancy and the effects of diagnosis and treatment on clinical indicators,efficacy and safety

作　　者：王海霞 龚时鹏[2] WANG Haixia;GONG Shipeng(The First Clinical Medical College,Nanfang Hospital,SouthernMedical University,Guangzhou 510515,China;Department of Obstetrics and Gynecology,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学第一临床医学院,广州510515 [2]南方医科大学南方医院妇产科,广州510515

出　　处：《中国妇产科临床杂志》2023年第5期493-496,共4页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：南方医院院长基金面上项目(2019B019)。

摘　　要：目的探究剖宫产瘢痕妊娠(cesarean scar pregnancy,CSP)危险因素及诊治方案对临床指标、疗效和安全性的影响。方法选取2019年6月至2021年6月在南方医科大学南方医院妇科住院手术的122例CSP患者纳入研究组,根据超声和手术方式分组:Ⅰ型纳入A1组;Ⅱ型纳入A2组和B2组;Ⅲ型纳入A3、B3和C3组。选取90例正常宫内妊娠孕妇,纳入对照组。Logistic回归多因素分析影响CSP发病危险因素;对比不同组别CSP手术成功、疗效、术后并发症。结果Logistic回归结果显示剖宫产术后人工流产次数≥1次、单层缝合及胎盘粘连是发病的危险因素(P<0.05);C3组成功率明显高于A3组,A1组和A2组成功率显著高于A3组;B2组平均孕囊大小和手术时间均高于A2组;C3组患者孕囊大小、手术时间均显著高于A3和B3组;术中出血、HCG恢复时间和月经恢复时间显著低于A3和B3组;B3组孕囊大小、手术时间均显著高于A3组;术中出血、HCG恢复时间和月经恢复时间均显著低于A3组(P<0.05)。结论剖宫产术后人工流产次数、单层缝合及存在胎盘黏连是影响CSP发病危险因素;应根据出血风险和分型特点选择CSP手术方式,保证其临床效果和安全性。Objective To explore the influence of cesarean scar pregnancy(CSP)risk factors and diagnosis and treatment plans on clinical indicators,efficacy and safety,and provide a basis for the diagnosis and treatment of clinical CSP patients.Methods From June 2019 to June 2021,122 patients with CSP in the Gynecology Department of the First Affiliated Hospital of Southern Medical University were selected in the research group,and were divided into two groups according to ultrasound and surgical methods:type Ⅰ was included in group A1;type Ⅱ was included in group A2 Group and Group B2;Type Ⅲ was included in Group A3,B3 and C3.A total of 90 pregnant women with normal intrauterine pregnancy were selected as the control group.Logistic regression multivariate analysis was used to analyze the risk factors for the incidence of CSP;the success curative effect and postoperative complications of CSP in different groups were compared.Results Logistic regression results showed that the risk factors include:induced abortions more than one time after cesarean section,single-layer suture and placental adhesion(P<0.05).Comparing the success rate of the same type of CSP,the C3 group was significantly higher than the A3 group(P<0.05);Comparing different types,the power of group A1 and group A2 was significantly higher than that of group A3(P<0.05);The average gestational sac size and operation time in group B2 were higher than those in group A2(P<0.05);The size of the gestational sac and the operation time of the patients in the C3 group were significantly higher than those in the A3 and B3 groups,and the intraoperative bleeding,HCG recovery time and menstrual recovery time were significantly lower than those in the A3 and B3 groups(P<0.05);The size of gestational sac and operation time in group B3 were significantly higher than those in group A3,and the intraoperative bleeding,HCG recovery time and menstrual recovery time were significantly lower than those in A3 group(P<0.05).Conclusion The number of induced abortions,single-layer s

关 键 词：LOGISTICS 瘢痕妊娠 危险因素 诊治方案 

分 类 号：R714.22[医药卫生—妇产科学]