孕囊型剖宫产瘢痕部位妊娠治疗失败的相关因素分析

发布时间：2018-06-28 06:00

本文选题：超声监视下清宫术 + 孕囊型剖宫产瘢痕部位妊娠　；参考：《实用妇产科杂志》2017年11期

【摘要】：目的:探讨孕囊型剖宫产瘢痕部位妊娠(CSP)超声监视下清宫术失败及失败后宫腔填塞压迫止血再失败的相关因素。方法:总结2006年7月至2016年7月于河北医科大学第二医院行超声监视下清宫术治疗的291例孕囊型CSP患者的病历资料,采用Logistic回归分析超声监视下清宫术失败及失败后宫腔填塞压迫止血再失败的相关因素。结果:超声监视下清宫术失败率为15.8%(46/291),清宫失败后28.3%(13/46)患者通过宫腔填塞压迫止血失败。经Logistic回归分析表明,超声监视下清宫术失败的相关因素是超声分型(OR 7.773,95%CI 3.038~19.885)、头臀长(OR5.561,95%CI 2.974~10.400)、血流分级(OR 2.420,95%CI 1.400~4.183)和术前血β-HCG水平(OR 1.914,95%CI 1.113~3.293)。宫腔填塞压迫止血失败的相关因素是血流分级(OR 19.738,95%CI 2.596~150.058)。结论:超声分型中级别越高、头臀长越长、孕囊及其周围血流越丰富、术前血β-HCG水平越高,清宫失败的可能性越大。清宫术失败后,孕囊及其周围血流越丰富,宫腔填塞压迫止血失败的风险相对较高。
[Abstract]:Objective: to investigate the factors related to the failure of cesarean scar pregnancy (CSP) under ultrasound monitoring and the failure of uterine cavity packing and hemostasis. Methods: from July 2006 to July 2016, 291 cases of gestational cystic CSP who were treated with ultrasonography under the supervision of uterine cleaning in the second Hospital of Hebei Medical University were reviewed. Logistic regression analysis was used to analyze the factors related to the failure of uterine cavity tamponade and hemostasis. Results: the failure rate of hysteroscopy was 15.8% (46 / 291). After the failure, 28.3% (13 / 46) patients failed to stop bleeding by intrauterine tamponade. Logistic regression analysis showed that the factors related to the failure of hysteria under ultrasound monitoring were ultrasonic typing (OR 7.77395 CI 3.038 卤19.885), head and hip length (OR 5.56195), CI 2.97410.400, blood flow grade (OR 2.420 卤95CI 1.4004.183) and preoperative serum 尾 -HCG level (OR 1.91495 CI 1.113 卤3.293). The blood flow grade (OR 19.73895 CI 2.596150.058) was related to the failure of uterine packing. Conclusion: the higher the grade of ultrasonic classification, the longer the length of head and hip, the richer the blood flow of pregnancy sac and its surrounding, the higher the serum 尾 -HCG level before operation, the greater the possibility of uterine failure. The more abundant the blood flow of pregnancy sac and its surrounding, the higher the risk of failure of uterine cavity tamponade and compression hemostasis.
【作者单位】：河北医科大学第二医院;
【分类号】：R714.22

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