上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

异位妊娠患者输卵管破裂危险因素研究

肖世金1,2，武玉鹏1,2，刘伟1,2   

  1. 上海交通大学 医学院 1.附属仁济医院南院妇产科， 上海 201112； 2.附属仁济医院妇产科, 上海 200127
  • 出版日期:2015-12-28 发布日期:2016-01-21
  • 通讯作者: 刘伟, 电子信箱: liuwei947@163.com。
  • 作者简介:肖世金（1983—）， 男， 主治医师， 硕士; 电子信箱: shjxiao@sina.com。
  • 基金资助:

    上海交通大学医学院附属仁济医院南院科研启动基金培育项目（2014QDM07）

Risk factors of tubal ruptures of patients with eccyesis

XIAO Shi-jin1,2, WU Yu-peng1,2, LIU Wei1,2   

  1. 1.Department of Obstetrics and Gynecology, Renji Hospital South Campus, Shanghai Jiao Tong University School of Medicine, Shanghai 201112， China； 2.Department of Obstetrics and Gynecology, Renji Hospital， Shanghai Jiao Tong University School of Medicine,Shanghai 200127, China
  • Online:2015-12-28 Published:2016-01-21
  • Supported by:

    Breeding Project of Scientific Research Initial Foundation of Renji Hospital South Campus， Shanghai Jiao Tong University School of Medicine, 2014QDM07

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摘要：

目的  探讨异位妊娠患者输卵管妊娠破裂的危险因素。方法  收集2013—2014年上海交通大学医学院附属仁济医院南院收治的输卵管妊娠患者的临床资料，并进行回顾性分析。209例患者中，58例为破裂型输卵管妊娠（破裂组），151例为流产型输卵管妊娠（非破裂组），疾病诊断依据手术和病理学检查结果，对异位妊娠输卵管破裂发生的危险因素进行统计学分析。结果  两组患者生育史、一般腹痛、撕裂性腹痛、阴道出血天数、术前血红蛋白、B超包块最大径线及盆腔积液量的差异有统计学意义（P<0.05）。经多因素logistic逐步回归分析，最终引入回归方程的变量为年龄、人工流产史、节育环、一般腹痛、撕裂性腹痛、盆腔积液量、B超包块最大径线。结论  年龄、节育环、撕裂性腹痛、B超包块最大径线、盆腔积液量是输卵管妊娠破裂的危险因素，而人工流产史则是保护因素。在临床决策时，需要考虑以上因素以避免输卵管妊娠破裂的发生而危及患者生命。

关键词: 输卵管妊娠, 破裂, 危险因素

Abstract:

Objective  To explore the risk factors of tubal ruptures of patients with eccyesis. Methods  Clinical data of 209 patients with tubal pregnancy who were admitted by Renji Hospital South Campus, Shanghai Jiao Tong University School of Medicine from 2013 to 2014 were collected and retrospectively analyzed. Among them, 58 cases were diagnosed with ruptured tubal pregnancy (rupture group) and 151 cases were diagnosed with un-ruptured tubal pregnancy (un-rupture group). Diagnoses were made depending on the results of surgical and pathological examinations. Risk factors of ruptured fallopian tubal pregnancy were statistically analyzed. Results  The differences of reproductive history, abdominal pain, presence of tear abdominal pain, vaginal bleeding days, hemoglobin level before operation, the biggest diameter line of the lump under B ultrasound, and pelvic cavity effusion between two groups were statistically significant (P<0.05). According to multiple factors logistic stepwise regression analysis, age, history of abortion, contraceptive ring, tear abdominal pain, pelvic cavity effusion, and the biggest diameter line of the lump under B ultrasound were introduced as variables of regression equation. Conclusion  Age, contraceptive ring, tear abdominal pain, the biggest diameter line of the lump under B ultrasound, and pelvic cavity effusion are risk factors of ruptured tubal pregnancy, while abortion history is the protection factor. Above factors should be considered for clinical decisions to avoid ruptured tubal pregnancy and endangering patients' lives.

Key words: tubal pregnancy, ruptured, risk factor