基于彩色多普勒超声参数、临床特征分析瘢痕妊娠手术后大出血危险因素  

Analysis of the risk factors of the massive bleeding of patients with scar pregnancy based on their color Doppler ultrasound parameters and clinical features

作　　者：范方裕 周柱玉[1] 辛艳芬[1] FAN Fangyu;ZHOU Zhuyu;XIN Yanfen(Deyang Peoples Hospital,Deyang,Sichuan Province,618000)

机构地区：[1]四川省德阳市人民医院,618000

出　　处：《中国计划生育学杂志》2025年第1期164-168,共5页Chinese Journal of Family Planning

基　　金：德阳市科技计划项目(重点研发)(2021522108)。

摘　　要：目的:基于彩色多普勒超声参数、临床特征分析瘢痕妊娠术后大出血的危险因素。方法:回顾性纳入2021年1月-2023年12月本院收治的瘢痕妊娠孕妇267例临床资料,其中术后大出血62例,非大出血205例,分析两组一般资料、彩色多普勒超声参数、临床特征,通过多因素logistic分析瘢痕妊娠手术后大出血发生危险因素。结果:267例瘢痕妊娠手术治疗后大出血62例(大出血组)、非大出血205例(非大出血组),大出血发生率为23.2%,两组剖宫产次数、妊娠囊平均直径、病灶残余肌层厚度、病灶类型、血流分级、腹痛占比有差异(P<0.05)。多因素logistic分析,剖宫产次数多、妊娠囊平均直径大、病灶类型为包块型、血流分级三级、腹痛为瘢痕妊娠手术后发生大出血的危险因素(OR=1.670、2.024、2.121、2.445、1.637,P<0.05),病灶残余肌层厚度增加为瘢痕妊娠大出血的保护因素(OR=0.524,P<0.05)。结论:剖宫产次数多、妊娠囊平均直径大、病灶残余肌层厚度降低、病灶类型为包块型、血流分级三级、腹痛为瘢痕妊娠大出血的危险因素。临床应予以重视。Objective:To analyze the risk factors of the massive bleeding of patients with scar pregnancy based on their color Doppler ultrasound parameters and clinical features.Methods:The clinical data of the patients with scar pregnancy who admitted in the hospital from January 2021 to December 2023 were included retrospectively.Among these patients,there were 62 patients with massive hemorrhage in group A and 205 patients without massive hemorrhage in group B,The general data,the parameters of color Doppler ultrasound and the clinical features of the patients in the two groups were analyzed,and the risk factors of the massive hemorrhage of the patients with scar pregnancy were analyzed by multivariate logistic analysis.Results:267 patients were treated with the scar pregnancy surgery,including 62 in group A and 205 in group B,and with the incidence of the massive hemorrhage of 23.2%.There were significant differences in the number of cesarean sections,the average diameter of gestational sac,the residual muscle thickness of the lesion,the type of lesion,the blood flow grade and the proportion of abdominal pain of the patients between the two groups(P<o.05).Multivariate logistic analysis showed that the great number of cesarean sections,the larger average diameter of gestational sac,the mass type of lesion,the 3 grade of blood flow and the abdominal pain of the patients were the risk factors of their massive hemorrhage after the scar pregnancy surgery(OR=1.670,2.024,2.121,2.445 and 1.637,P<0.05).The increased thickness of the lesion residual muscular layer of the patients was a protective factor of their massive hemorrhage after the scar pregnancy surgery(OR=0.524,P<0.05).Conclusion:The great number of cesarean sections,the larger average diameter of gestational sac,the decreased thickness of the lesion residual muscular layer,the mass type of lesion,the 3 grade of blood flow and the abdominal pain of the patients are the risk factors of their massive hemorrhage after the scar pregnancy surgery,which should be paid attent

关 键 词：瘢痕妊娠 手术后大出血 彩色多普勒超声参数 临床特征 危险因素 

分 类 号：R445.1[医药卫生—影像医学与核医学] R713.8[医药卫生—诊断学]