高危型剖宫产瘢痕妊娠相关因素分析

发布时间：2018-10-29 15:52

【摘要】：目的探讨高危型剖宫产瘢痕妊娠(high risk-cesarean scar pregnancy,HR-CSP)影响其治疗结局的危险因素。方法采用回顾性病例对照研究方法,收集2008年3月至2014年12月近7年第三军医大学西南医院妇科住院且腹腔镜下成功治疗剖宫产瘢痕妊娠(cesarean scar pregnancy,CSP)患者105例,其中30例行腹腔镜病灶清除术为高危组,75例行腹腔镜监视下清宫术为低危组。提取所有出院病历中与研究相关的患者基本资料及手术记录。采用SPSS 17.0统计软件进行分析,确定高危型CSP的独立危险因素、相对危险度(odds ratio,OR)及95%可信区间(95%confidence interval,95%CI)。结果高危组与低危组停经时间(t=-4.485,P0.01)、超声测量病灶最大径线(t=-5.096,P0.01)、手术时间(t=-11.888,P0.01)、术中出血量(t=-5.110,P0.01)、住院天数(t=-3.290,P=0.001,P0.05)、超声分型:孕囊型/包块型(χ2=35.188,P0.01)、胎血管搏动:有/无(χ2=5.392,P=0.020,P0.05)差异有统计学意义;超声测量病灶最大径线(OR=1.042,95%CI:1.001~1.085)、超声分型:孕囊型/包块型(OR=14.122,95%CI:3.277~60.860)为高危型CSP发生的独立危险因素。结论剖宫产瘢痕妊娠时超声测量病灶最大径线及超声类型是影响剖宫产切口瘢痕妊娠治疗结局的独立危险因素。
[Abstract]:Objective to investigate the risk factors of high-risk cesarean scar pregnancy (high risk-cesarean scar pregnancy,HR-CSP). Methods A retrospective case-control study was carried out in 105 patients with cesarean scar pregnancy (cesarean scar pregnancy,CSP) treated successfully by laparoscope in Southwest Hospital of the third military Medical University from March 2008 to December 2014. Among them, 30 cases were high-risk group and 75 cases were low-risk group. The basic data and surgical records of all patients who were discharged from the hospital were extracted. The independent risk factors, relative risk (odds ratio,OR) and 95% confidence interval (95%confidence interval,95%CI) of high-risk CSP were determined by SPSS 17.0 statistical software. Results the menopause time of high risk group and low risk group (t = -4.485, P 0.01), the maximum diameter of lesion measured by ultrasound (t = 5.096, P 0.01), the time of operation (t, n = 11.888, P 0.01), the amount of intraoperative bleeding (t, n = -5.110), the time of operation (t = -11.88 8, P 0.01), the volume of bleeding during operation (t = -5.110). (P 0.01), hospitalization days (t = 3.290) (P 0.05), ultrasonic classification: gestational cystic type / mass type (蠂 ~ 2 ~ 2 ~ (35.188) P _ (0.01), fetal vascular pulsatility: yes or no (蠂 ~ 2 ~ (-5.392) P ~ (0.020), and (P _ (0.01), (P _ (0.01). P0.05) the difference was statistically significant; The maximum diameter (OR=1.042,95%CI:1.001~1.085) of the lesions was measured by ultrasound. The gestational cystic / mass type (OR=14.122,95%CI:3.277~60.860) was the independent risk factor for the development of high risk CSP. Conclusion Ultrasonic measurement of the maximum diameter of the lesion and the type of ultrasound are independent risk factors for the outcome of scar pregnancy in cesarean section.
【作者单位】：第三军医大学西南医院妇产科;第三军医大学西南医院超声科;
【基金】：重庆市科技攻关项目(CSTC2012gg-yyjs10056)~~
【分类号】：R714.2

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