中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2011年
21期
17-19
,共3页
张敏%邹红艳%杜敏%王箭%余荣萍
張敏%鄒紅豔%杜敏%王箭%餘榮萍
장민%추홍염%두민%왕전%여영평
妊娠,异位%流产,自然%体外受精-胚胎移植%盆腔输卵管病变
妊娠,異位%流產,自然%體外受精-胚胎移植%盆腔輸卵管病變
임신,이위%유산,자연%체외수정-배태이식%분강수란관병변
Pregnancy,ectopic%Abortion,spontaneous%In vitro fertilization and embryo transfer%Pathological changes of the pelvic cavity and fallopian tube
目的 探讨盆腔输卵管不同病变对体外受精-胚胎移植(IVF-ET)妊娠结局的影响.方法 将1032例行IVF-ET患者分为盆腔输卵管病变组(605例)和非盆腔输卵管病变组(427例).盆腔输卵管病变组患者再根据输卵管病变部位不同分为输卵管阻塞组(243例)、输卵管切除组(104例)、输卵管造口组(149例)、输卵管积水组(109例);再根据是否合并盆腔病变分为合并盆腔病变组(194例)、非合并盆腔病变组(411例).对各组患者的临床妊娠、异位妊娠、自然流产情况进行回顾性分析.结果 盆腔输卵管病变组异位妊娠率和自然流产率[10.63%(27/254)和9.06%(23/254)]高于非盆腔输卵管病变组[3.27%(5/153)和4.58%(7,153)](P<0.01或<0.05).输卵管切除组异位妊娠率最低[2.17%(1/46)],输卵管造口组最高[22.41%(13/58)],各组比较差异有统计学意义(P<0.01).输卵管造口组和输卵管积水组自然流产率[10.34%(6/58)和15.00%(6/40)]明显高于输卵管阻塞组和输卵管切除组[7.27%(8/110)和6.52%(3/46)](P<0.05).合并盆腔病变组自然流产率[11.54%(9/78)]高于非合并盆腔病变组[7.95%(14/176)](P<0.05).结论 盆腔输卵管病变是发生异位妊娠及自然流产的高危因素,应加强IVF-ET术前对盆腔输卵管情况的评估与治疗.
目的 探討盆腔輸卵管不同病變對體外受精-胚胎移植(IVF-ET)妊娠結跼的影響.方法 將1032例行IVF-ET患者分為盆腔輸卵管病變組(605例)和非盆腔輸卵管病變組(427例).盆腔輸卵管病變組患者再根據輸卵管病變部位不同分為輸卵管阻塞組(243例)、輸卵管切除組(104例)、輸卵管造口組(149例)、輸卵管積水組(109例);再根據是否閤併盆腔病變分為閤併盆腔病變組(194例)、非閤併盆腔病變組(411例).對各組患者的臨床妊娠、異位妊娠、自然流產情況進行迴顧性分析.結果 盆腔輸卵管病變組異位妊娠率和自然流產率[10.63%(27/254)和9.06%(23/254)]高于非盆腔輸卵管病變組[3.27%(5/153)和4.58%(7,153)](P<0.01或<0.05).輸卵管切除組異位妊娠率最低[2.17%(1/46)],輸卵管造口組最高[22.41%(13/58)],各組比較差異有統計學意義(P<0.01).輸卵管造口組和輸卵管積水組自然流產率[10.34%(6/58)和15.00%(6/40)]明顯高于輸卵管阻塞組和輸卵管切除組[7.27%(8/110)和6.52%(3/46)](P<0.05).閤併盆腔病變組自然流產率[11.54%(9/78)]高于非閤併盆腔病變組[7.95%(14/176)](P<0.05).結論 盆腔輸卵管病變是髮生異位妊娠及自然流產的高危因素,應加彊IVF-ET術前對盆腔輸卵管情況的評估與治療.
목적 탐토분강수란관불동병변대체외수정-배태이식(IVF-ET)임신결국적영향.방법 장1032례행IVF-ET환자분위분강수란관병변조(605례)화비분강수란관병변조(427례).분강수란관병변조환자재근거수란관병변부위불동분위수란관조새조(243례)、수란관절제조(104례)、수란관조구조(149례)、수란관적수조(109례);재근거시부합병분강병변분위합병분강병변조(194례)、비합병분강병변조(411례).대각조환자적림상임신、이위임신、자연유산정황진행회고성분석.결과 분강수란관병변조이위임신솔화자연유산솔[10.63%(27/254)화9.06%(23/254)]고우비분강수란관병변조[3.27%(5/153)화4.58%(7,153)](P<0.01혹<0.05).수란관절제조이위임신솔최저[2.17%(1/46)],수란관조구조최고[22.41%(13/58)],각조비교차이유통계학의의(P<0.01).수란관조구조화수란관적수조자연유산솔[10.34%(6/58)화15.00%(6/40)]명현고우수란관조새조화수란관절제조[7.27%(8/110)화6.52%(3/46)](P<0.05).합병분강병변조자연유산솔[11.54%(9/78)]고우비합병분강병변조[7.95%(14/176)](P<0.05).결론 분강수란관병변시발생이위임신급자연유산적고위인소,응가강IVF-ET술전대분강수란관정황적평고여치료.
Objective To evaluate the effect of the pathological changes of the pelvic cavity and fallopian tube on the outcome of in vitro fertilization and embryo transfer(IVF-ET).Method One thousand and thirty-two patients who underwent IVF-ET were divided into tubal and pelvic infertile group(605 cases)and non-tubal and pelvic infertile group(427 cases).The tubal and pelvic infertile group was also divided into salpingemphraxis group(243 cases),tubal resection group(104 cases),fallostomy group(149 cases),tubal dropsy group(109 cages)according to the tubal lesion regions,and combined with pelvic group(194 cases),combined without pelvic group(411 cases).The data of clinical pregnancy,ectopic pregnancy,and abortion was analyzed respectively.Results The ectopic pregnancy and abortion rates in tubal and pelvic infertile group[10.63%(27/254)and 9.06%(23/254)]were higher than those in non-tubal and pelvic infertile group [3.27%(5/153)and 4.58%(7/153)](P<0.01 or<0.05).The ectopic pregnancy rate was the lowest in tubal resection group[2.17%(1/46)],the highest in fallostomy group[22.41%(13/58)],there was significant difference among the groups(P<0.01).The abortion rate in fallostomy group and tubal dropsy group[10.34%(6/58)and 15.00%(6/40)]was higher than that in salpingemphraxis group and tubal resection group [7.27%(8/110)and 6.52%(3/46)],there was significant difference among the groups(P<0.05).The abortion rate in combined with pelvic group[11.54%(9/78)]was higher than that in combined without pelvic group[7.95%(14/176)](P<0.05).Conclusions The pathological changes of the pelvic cavity and fallopian tube are higher risk factors of ectopic pregnancy and abortion occurrence.The assessment and treatment of pelvic cavity and fallopian tube before assisted reproductive treatment cycles should be enhanced.
