异位妊娠破裂相关因素分析

An associated analysis of clinical factors of ectopic pregnancy and rupture

目的阐明异位妊娠各临床病理因素与破裂的相互关系,为手术前准确判断异位妊娠破裂,及时手术提供依据。方法回顾性分析广州市红十字会医院妇产科2008年1月-2010年6月手术治疗的243例异位妊娠患者的临床病理因素与破裂的相互关系。结果①单因素分析显示：孕囊着床部位、盆腔积血量多少、术前血红蛋白与血清β-HCG值、腹痛类型、阴道流血情况以及B超盆腔包块直径等与异位妊娠破裂相关;②Lo-gistic回归分析显示：仅有盆腔积血量、孕囊着床部位及B超盆腔包块直径是影响异位妊娠破裂的独立危险因素。结论盆腔积血〉1 000 mL、峡部妊娠以及B超附件包块直径〉4 cm有利于异位妊娠破裂的诊断。

【Objective】 To clarify the relationship of clinical pathological factors and ruptured ectopic pregnancy,accurately judge whether the focus of ectopic pregnancy has ruptured preoperatively,and provide theoretic evidence for timely operation.【Methods】 The clinical data of 243 patients with ectopic pregnancy who received operation in Guangzhou Red Cross Hospital from January 2008 to July 2010 were analyzed retrospectively,and the mutual relationship of clinical pathological factors and ruptured ectopic pregnancy were clarified.【Results】 ①Univariate analysis shows that some clinical factors such as the planting position,the amount of pelvic bleeding,the mass size of annex,the value of serum hemoglobin and β-HCG before operation,the type of abdominal pain and bleeding of vagina were associated with the rupture of ectopic pregnancy;②Logistic regression analysis shows that only the planting position,the amount of pelvic bleeding,the mass size of annex of B ultrasound were independent risk factors of rupture.【Conclusion】 The isthmus pregnancy of tubal,more pelvic bleeding（〉1000 mL） and bigger annex mass（d〉4 cm） were benefit for the prognosis of ruptured ectopic pregnancy.