二孩政策实施前后异位妊娠临床特征的变化分析  

Changes of Clinical Characteristics of Ectopic Pregnancy Before and After the Implementation of the Two-child Policy

作　　者：李璟[1,2,3] 光晓燕 于琳[1,2,3] 魏蔚霞 钟世林[1,2,3] LI Jing;GUANG Xiao-yan;YU Lin;WEI Wei-xia;ZHONG Shi-lin(Department of Obstetrics and Gynecology,Peking University Shenzhen Hospital,Shenzhen 518036,Guangdong,China;Institute of Obstetrics and Gynecology,Shenzhen PKU-HKUST Medical Center,Shenzhen 518036,Guangdong,China;Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecologic Diseases,Shenzhen 518036,Guangdong,China)

机构地区：[1]北京大学深圳医院妇产科,广东深圳518036 [2]深圳北京大学香港科技大学医学中心妇产科学研究所,广东深圳518036 [3]深圳市女性重大疾病早期诊断技术重点实验室,广东深圳518036

出　　处：《医学信息》2023年第23期13-16,29,共5页Journal of Medical Information

基　　金：深圳市高水平医院建设专项经费(编号:粤办函[2019]260号);深圳市医学重点学科建设经费(编号:SZXK027);深圳市“医疗卫生三名工程”项目(编号:SZSM202011016);深圳市科技计划项目(编号:JCYJ20160428172000077、JCYJ20210324110206017)

摘　　要：目的探讨二孩政策实施对异位妊娠类型、治疗方式及合并症的影响。方法选择2009年12月-2021年5月北京大学深圳医院住院的异位妊娠患者作为研究对象。根据二孩政策实施时间2016年1月作为分界,分为政策前组和政策后组,对比两组患者中异位妊娠的类型、发病年龄、治疗方式及各类合并症的比例等临床特征。结果共有5572例患者纳入研究,与政策前组比较,政策后组中子宫瘢痕部位妊娠的比例升高(P=0.000),≤29岁患者异位妊娠比例下降(P=0.000),而30~39岁患者异位妊娠比例升高(P=0.000),40~49岁患者异位妊娠比例无显著变化,选择腹腔镜手术的比例升高(P=0.000),选择保留输卵管手术的比例无显著变化,异位妊娠并发失血性贫血的比例下降(P=0.000),异位妊娠并发失血性休克的比例无显著变化。二孩政策实施后,异位妊娠患者合并输卵管疾病、子宫疾病、盆腔粘连、子宫内膜异位症的比例增加(P<0.05),而合并卵巢疾病的比例无显著变化。结论二孩政策实施后,子宫瘢痕部位妊娠的比例、异位妊娠患病年龄、腹腔镜手术治疗的比例均有增加趋势,输卵管疾病、子宫疾病、盆腔粘连、子宫内膜异位症等风险因素在异位妊娠患者中更加常见。Objective To explore the effect in implementation of two-child policy in China on the types,treatment and complication of ectopic pregnancy.Methods Patients with ectopic pregnancy who were hospitalized in Peking University Shenzhen Hospital from December 2009 to May 2021 were selected as the research objects.According to the implementation time of the two-child policy in January 2016,they were divided into the pre-two-child policy group and the after-two-child policy group.The clinical characteristics of ectopic pregnancy,age of onset,treatment methods,and the proportion of various complications were compared between the two groups.Results A total of 5572 patients were included in the study.Compared with pre-two-child policy group,the proportion of uterine scar pregnancy in the after-two-child policy group increased(P=0.000),the proportion of ectopic pregnancy in patients aged≤29 years old decreased(P=0.000),while the proportion of ectopic pregnancy in patients aged 30-39 years old increased(P=0.000),there was no significant change in the proportion of ectopic pregnancy in patients aged 40-49 years old,the proportion of laparoscopic surgery increased(P=0.000),there was no significant change in the proportion of tubal preservation surgery,the proportion of ectopic pregnancy complicated with hemorrhagic anemia decreased(P=0.000),there was no significant change in the proportion of ectopic pregnancy complicated with hemorrhagic shock.After the implementation of the two-child policy,the proportion of patients with ectopic pregnancy complicated with tubal disease,uterine disease,pelvic adhesions,and endometriosis increased(P<0.05),while there was no significant change in proportion of patients with ovarian disease.Conclusion After the implementation of the two-child policy,the proportion of uterine scar pregnancy,the age of ectopic pregnancy,and the proportion of laparoscopic surgery have an increasing trend.Risk factors such as tubal disease,uterine disease,pelvic adhesions,and endometriosis are more common in pati

关 键 词：异位妊娠 输卵管妊娠 腹腔镜手术 子宫瘢痕部位妊娠 二孩政策 

分 类 号：R714[医药卫生—妇产科学]