Chinese General Practice ›› 2024, Vol. 27 ›› Issue (12): 1475-1479.DOI: 10.12114/j.issn.1007-9572.2023.0476
• Original Research • Previous Articles Next Articles
Received:
2023-04-20
Revised:
2023-10-15
Published:
2024-04-20
Online:
2024-01-23
Contact:
LI Huajun
通讯作者:
李华军
作者简介:
基金资助:
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URL: https://www.chinagp.net/EN/10.12114/j.issn.1007-9572.2023.0476
组别 | 例数 | 年龄(岁) | ≥35岁[例(%)] | 现孕次[M(P25,P75),次] | 经产次[M(P25,P75),次] | 剖宫产≥2次[例(%)] | 首次剖宫产时机[例(%)] | |
---|---|---|---|---|---|---|---|---|
未足月剖宫产 | 未临产剖宫产 | |||||||
Ⅰ型组 | 315 | 34.9±4.8 | 164(52.1) | 4(3,5) | 1(1,2) | 93(29.5) | 17(5.4) | 280(88.9) |
Ⅱ型组 | 458 | 34.4±4.4 | 226(49.3) | 4(3,5) | 1(1,2) | 165(36.0) | 15(3.3) | 410(89.5) |
Ⅲ型组 | 89 | 34.2±4.8 | 41(46.1) | 4(3,5) | 1(1,2) | 31(34.8) | 4(4.5) | 80(89.9) |
检验统计量值 | 1.186a | 1.166b | 4.928 | 4.111 | 3.617b | 2.125b | 0.111b | |
P值 | 0.306 | 0.558 | 0.085 | 0.128 | 0.164 | 0.346 | 0.946 | |
组别 | 受孕方式[例(%)] | 妊娠间隔[M(P25,P75),年]c | CSP病史[例(%)] | 宫腔手术史[例(%)]d | 宫腔手术次[M(P25,P75),次] | |||
自然受孕 | IVF-ET | 无 | 仅有剖宫产术前宫腔手术史 | 有剖宫产术后宫腔手术史 | ||||
Ⅰ型组 | 299(94.9) | 16(5.1) | 6(3,10) | 13(4.1) | 70(22.2) | 64(20.3) | 181(57.5) | 1(1,2) |
Ⅱ型组 | 442(96.5) | 16(3.5) | 5(3,8) | 23(5.0) | 112(24.4) | 92(20.1) | 254(55.5) | 1(1,2) |
Ⅲ型组 | 87(97.8) | 2(2.2) | 5(3,8) | 6(6.7) | 16(18.0) | 16(18.0) | 57(64.0) | 2(1,2) |
检验统计量值 | 1.982b | 4.397 | 1.071b | 2.656b | 2.702 | |||
P值 | 0.371 | 0.111 | 0.586 | 0.617 | 0.259 |
Table 1 Comparison of general clinical data of patients in 3 groups
组别 | 例数 | 年龄(岁) | ≥35岁[例(%)] | 现孕次[M(P25,P75),次] | 经产次[M(P25,P75),次] | 剖宫产≥2次[例(%)] | 首次剖宫产时机[例(%)] | |
---|---|---|---|---|---|---|---|---|
未足月剖宫产 | 未临产剖宫产 | |||||||
Ⅰ型组 | 315 | 34.9±4.8 | 164(52.1) | 4(3,5) | 1(1,2) | 93(29.5) | 17(5.4) | 280(88.9) |
Ⅱ型组 | 458 | 34.4±4.4 | 226(49.3) | 4(3,5) | 1(1,2) | 165(36.0) | 15(3.3) | 410(89.5) |
Ⅲ型组 | 89 | 34.2±4.8 | 41(46.1) | 4(3,5) | 1(1,2) | 31(34.8) | 4(4.5) | 80(89.9) |
检验统计量值 | 1.186a | 1.166b | 4.928 | 4.111 | 3.617b | 2.125b | 0.111b | |
P值 | 0.306 | 0.558 | 0.085 | 0.128 | 0.164 | 0.346 | 0.946 | |
组别 | 受孕方式[例(%)] | 妊娠间隔[M(P25,P75),年]c | CSP病史[例(%)] | 宫腔手术史[例(%)]d | 宫腔手术次[M(P25,P75),次] | |||
自然受孕 | IVF-ET | 无 | 仅有剖宫产术前宫腔手术史 | 有剖宫产术后宫腔手术史 | ||||
Ⅰ型组 | 299(94.9) | 16(5.1) | 6(3,10) | 13(4.1) | 70(22.2) | 64(20.3) | 181(57.5) | 1(1,2) |
Ⅱ型组 | 442(96.5) | 16(3.5) | 5(3,8) | 23(5.0) | 112(24.4) | 92(20.1) | 254(55.5) | 1(1,2) |
Ⅲ型组 | 87(97.8) | 2(2.2) | 5(3,8) | 6(6.7) | 16(18.0) | 16(18.0) | 57(64.0) | 2(1,2) |
检验统计量值 | 1.982b | 4.397 | 1.071b | 2.656b | 2.702 | |||
P值 | 0.371 | 0.111 | 0.586 | 0.617 | 0.259 |
组别 | 例数 | 腹痛[例(%)] | 阴道出血[例(%)] | 停经时间[M(P25,P75),d] | 停经≥8周[例(%)] | 妊娠物径线[M(P25,P75),mm] | 术前血β-HCG [M(P25,P75),mU/mL] | ||
---|---|---|---|---|---|---|---|---|---|
Ⅰ型组 | 315 | 79(25.1) | 190(60.3) | 47(41,53) | 66(21.0) | 16.3(9.9,22.5) | 28 711(10 953,73 998) | ||
Ⅱ型组 | 458 | 103(22.5) | 306(66.8) | 47(42,55) | 111(24.2) | 20.3(13.0,27.0)a | 48 943(17 902,100 646)a | ||
Ⅲ型组 | 89 | 27(30.3) | 64(71.9) | 55(46,64)ab | 43(48.9)ab | 29.6(19.1,43.3)ab | 60 673(17 164,122 203)a | ||
H(χ2)值 | 2.687c | 5.562c | 26.927 | 29.060c | 77.681 | 21.806 | |||
P值 | 0.261 | 0.062 | <0.001 | <0.001 | <0.001 | <0.001 | |||
组别 | 超声胎心搏动[例(%)] | 围术期药物杀胚治疗[例(%)] | 超声监测下手术[例(%)] | 腹腔镜监视下手术[例(%)] | 子宫动脉阻断[例(%)] | 手术方式[例(%)] | |||
宫腔镜妊娠病灶清除术 | 负压吸引清宫术 | 腹腔镜妊娠病灶切除+子宫修补术 | 开腹妊娠病灶切除+子宫修补术 | ||||||
Ⅰ型组 | 119(37.8) | 32(10.2) | 36(11.4) | 32(10.2) | 26(8.3) | 308(97.8) | 4(1.3) | 1(0.3) | 2(0.6) |
Ⅱ型组 | 192(41.9) | 82(17.9)a | 102(22.3)a | 79(17.2)a | 96(21.0)a | 431(94.1)a | 13(2.8) | 8(1.7) | 6(1.3) |
Ⅲ型组 | 37(41.6) | 24(27.0)a | 11(12.4) | 30(33.7)ab | 29(32.6)a | 31(34.8)ab | 3(3.4) | 19(21.3)ab | 36(40.4)ab |
H(χ2)值 | 1.391c | 17.188c | 17.029c | 28.695c | 36.449c | 380.069c | |||
P值 | 0.499 | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | |||
组别 | 手术时长[M(P25,P75),min] | 宫腔球囊压迫止血[例(%)] | 术后24 h累计出血量(mL) | 出血≥200 mL [例(%)] | 输血[例(%)] | 住院时间[M(P25,P75),d] | 治疗费用[M(P25,P75),元] | 持续性CSP [例(%)] | |
Ⅰ型组 | 30(21,49) | 62(19.7) | 22(13,40) | 11(3.5) | 2(0.6) | 2(2,3) | 5 367.7(4 664.5,6 374.3) | 6(1.9) | |
Ⅱ型组 | 37(25,58)a | 117(25.5) | 23(13,53)a | 37(8.1)a | 10(2.2) | 2(2,4) | 6 070.4(5 109.3,9 525.9)a | 19(4.1) | |
Ⅲ型组 | 101(67,125)ab | 22(24.7) | 83(33,178)ab | 22(24.7)ab | 7(7.9)ab | 4(3,7)ab | 11 933.7(8 760.7,15 250.6)ab | 2(2.2) | |
H(χ2)值 | 128.709 | 3.697c | 79.807 | 41.910c | 16.831c | 54.928 | 137.746 | 3.353c | |
P值 | <0.001 | 0.157 | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | 0.187 |
Table 2 Comparison of diagnosis and treatment indicators of patients in 3 groups
组别 | 例数 | 腹痛[例(%)] | 阴道出血[例(%)] | 停经时间[M(P25,P75),d] | 停经≥8周[例(%)] | 妊娠物径线[M(P25,P75),mm] | 术前血β-HCG [M(P25,P75),mU/mL] | ||
---|---|---|---|---|---|---|---|---|---|
Ⅰ型组 | 315 | 79(25.1) | 190(60.3) | 47(41,53) | 66(21.0) | 16.3(9.9,22.5) | 28 711(10 953,73 998) | ||
Ⅱ型组 | 458 | 103(22.5) | 306(66.8) | 47(42,55) | 111(24.2) | 20.3(13.0,27.0)a | 48 943(17 902,100 646)a | ||
Ⅲ型组 | 89 | 27(30.3) | 64(71.9) | 55(46,64)ab | 43(48.9)ab | 29.6(19.1,43.3)ab | 60 673(17 164,122 203)a | ||
H(χ2)值 | 2.687c | 5.562c | 26.927 | 29.060c | 77.681 | 21.806 | |||
P值 | 0.261 | 0.062 | <0.001 | <0.001 | <0.001 | <0.001 | |||
组别 | 超声胎心搏动[例(%)] | 围术期药物杀胚治疗[例(%)] | 超声监测下手术[例(%)] | 腹腔镜监视下手术[例(%)] | 子宫动脉阻断[例(%)] | 手术方式[例(%)] | |||
宫腔镜妊娠病灶清除术 | 负压吸引清宫术 | 腹腔镜妊娠病灶切除+子宫修补术 | 开腹妊娠病灶切除+子宫修补术 | ||||||
Ⅰ型组 | 119(37.8) | 32(10.2) | 36(11.4) | 32(10.2) | 26(8.3) | 308(97.8) | 4(1.3) | 1(0.3) | 2(0.6) |
Ⅱ型组 | 192(41.9) | 82(17.9)a | 102(22.3)a | 79(17.2)a | 96(21.0)a | 431(94.1)a | 13(2.8) | 8(1.7) | 6(1.3) |
Ⅲ型组 | 37(41.6) | 24(27.0)a | 11(12.4) | 30(33.7)ab | 29(32.6)a | 31(34.8)ab | 3(3.4) | 19(21.3)ab | 36(40.4)ab |
H(χ2)值 | 1.391c | 17.188c | 17.029c | 28.695c | 36.449c | 380.069c | |||
P值 | 0.499 | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | |||
组别 | 手术时长[M(P25,P75),min] | 宫腔球囊压迫止血[例(%)] | 术后24 h累计出血量(mL) | 出血≥200 mL [例(%)] | 输血[例(%)] | 住院时间[M(P25,P75),d] | 治疗费用[M(P25,P75),元] | 持续性CSP [例(%)] | |
Ⅰ型组 | 30(21,49) | 62(19.7) | 22(13,40) | 11(3.5) | 2(0.6) | 2(2,3) | 5 367.7(4 664.5,6 374.3) | 6(1.9) | |
Ⅱ型组 | 37(25,58)a | 117(25.5) | 23(13,53)a | 37(8.1)a | 10(2.2) | 2(2,4) | 6 070.4(5 109.3,9 525.9)a | 19(4.1) | |
Ⅲ型组 | 101(67,125)ab | 22(24.7) | 83(33,178)ab | 22(24.7)ab | 7(7.9)ab | 4(3,7)ab | 11 933.7(8 760.7,15 250.6)ab | 2(2.2) | |
H(χ2)值 | 128.709 | 3.697c | 79.807 | 41.910c | 16.831c | 54.928 | 137.746 | 3.353c | |
P值 | <0.001 | 0.157 | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | 0.187 |
[1] |
|
[2] |
|
[3] |
|
[4] |
中华医学会妇产科学分会计划生育学组. 剖宫产术后子宫瘢痕妊娠诊治专家共识(2016)[J]. 中华妇产科杂志,2016,51(8):568-572. DOI:10.3760/cma.j.issn.0529-567x.2016.08.003.
|
[5] |
姚颖,王超,曲·启明,等. 再发性剖宫产瘢痕妊娠10例分析[J]. 中国微创外科杂志,2019,19(3):212-216. DOI:10.3969/j.issn.1009-6604.2019.03.005.
|
[6] |
李英,张坤,韩劲松,等. 腹腔镜双侧子宫动脉阻断联合宫腔镜妊娠病灶清除治疗剖宫产瘢痕妊娠[J]. 中国微创外科杂志,2017,17(3):216-219. DOI:10.3969/j.issn.1009-6604.2017.03.007.
|
[7] |
张爱青,刘朝晖,赵文秋,等. 剖宫产切口瘢痕妊娠的声像图特征及临床分析[J]. 临床超声医学杂志,2008,10(9):622-624. DOI:10.16245/j.cnki.issn1008-6978.2008.09.021.
|
[8] |
种轶文,张坤,周延,等. MRI检查在剖宫产术后子宫瘢痕妊娠诊治中的应用价值[J]. 中华妇产科杂志,2014,49(12):914-918. DOI:10.3760/cma.j.issn.0529-567x.2014.12.007.
|
[9] |
张红霞,张坤,杨艳,等. 包块型剖宫产瘢痕妊娠的临床特点分析[J]. 中国微创外科杂志,2022,22(10):838-841. DOI:10.3969/j.issn.1009-6604.2022.10.014.
|
[10] |
徐丛剑,华克勤. 实用妇产科学[M]. 4版. 北京:人民卫生出版社,2018:884.
|
[11] |
王超,魏瑗,梁华茂,等. 剖宫产瘢痕部位妊娠发病的危险因素[J]. 中华医学杂志,2022,102(32):2495-2499. DOI:10.3760/cma.j.cn112137-20211208-02735.
|
[12] |
|
[13] |
|
[14] |
|
[15] |
康彦君,班艳丽,张腾,等. 子宫瘢痕妊娠实用临床分型及应用价值探讨[J]. 现代妇产科进展,2019,28(10):731-735. DOI:10.13283/j.cnki.xdfckjz.2019.10.003.
|
[16] |
|
[17] |
|
[18] |
|
[19] |
于梦,乔宠,侯悦,等. 双侧子宫动脉栓塞在剖宫产瘢痕妊娠中的临床应用[J]. 中国医科大学学报,2021,50(6):560-561. DOI:10.12007/j.issn.0258-4646.2021.06.018.
|
[20] | |
[21] |
温亚玲,王文珍,康瑾,等. 剖宫产瘢痕部位妊娠子宫动脉栓塞术后近远期并发症分析[J]. 中华解剖与临床杂志,2021,26(5):554-559. DOI:10.3760/cma.j.cn101202-20210323-00078.
|
[22] |
李凡,袁礼红,周萍. 剖宫产术后子宫瘢痕妊娠不同治疗方法的应用价值[J]. 中国全科医学,2019,22(7):830-833,838. DOI:10.12114/j.issn.1007-9572.2019.07.016.
|
[23] |
姜丽,曹云桂,张青. 持续性剖宫产瘢痕妊娠的临床特点分析[J]. 中国计划生育学杂志,2019,27(1):99-101. DOI:10.3969/j.issn.1004-8189.2019.01.025.
|
[24] |
|
[25] |
|
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