| 朱明凤，陶群▲.重复异位妊娠危险因素及甲氨蝶呤治疗重复与首次异位妊娠结局的分析[J].中国医药科学,2023,(20):70-73 基金项目: |
| 重复异位妊娠危险因素及甲氨蝶呤治疗重复与首次异位妊娠结局的分析 |
| Analysis of risk factors of recurrent ectopic pregnancy and the therapeutic outcomes of methotrexate in recurrent and primary ectopic pregnancy |
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| DOI： |
| 中文关键词: 重复异位妊娠；危险因素；甲氨蝶呤；异位妊娠 |
| 英文关键词:Recurrent ectopic pregnancy; Risk factors; Methotrexate; Ectopic pregnancy |
| 作者 | 单位 | | 朱明凤，陶群▲ | 安徽医科大学附属巢湖医院妇产科，安徽合肥 238000 |
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| 中文摘要: |
| [摘要] 目的 探讨重复异位妊娠（REP）发生的相关危险因素以及单剂量甲氨蝶呤（MTX）对REP和首次异位妊娠（PEP）患者治疗结局的分析。 方法 选取2016年1月至2022年1月于安徽医科大学附属巢湖医院住院并接受单剂量MTX治疗的143例输卵管妊娠患者为研究对象，根据异位妊娠（EP）的次数分为REP组（n=42）和PEP组（n=101），采用logistic回归分析方法对REP的相关危险因素进行分析。 结果 单因素分析结果显示，REP的发生与流产次数、盆腔炎症史、既往盆腔手术史有关，差异有统计学意义（P < 0.05），而与停经时间、输卵管妊娠包块大小、孕产次不相关，差异无统计学意义（P > 0.05）。多因素分析结果显示，流产次数≥2次、既往盆腔手术史是REP发生的独立危险因素（P < 0.05）。REP组的单剂量MTX治疗成功率明显低于PEP组（59.52% vs. 77.23%），差异有统计学意义（P < 0.05）。 结论 流产次数≥2次、既往盆腔手术史是REP发生的独立危险因素。在REP病例中，单剂量MTX方案的治疗成功率低于预期，提示在这种情况下应考虑不同的治疗方法。 |
| 英文摘要: |
| [Abstract] Objective To explore the risk factors of recurrent ectopic pregnancy (REP) and to analyze the therapeutic outcomes of single-dose methotrexate (MTX) in patients with REP and primary ectopic pregnancy (PEP). Methods A total of 143 tubal pregnancy patients who were admitted to Chaohu Hospital of Anhui Medical University and received single-dose MTX treatment from January 2016 to January 2022 were selected as the research subjects and divided into the REP group (n=42) and the PEP group (n=101) according to the number of ectopic pregnancies (EP). Logistic regression analysis was adopted to analyze the related risk factors of REP. Results The results of univariate analysis showed that the occurrence of REP was related to the number of abortions, the history of pelvic inflammation and the previous pelvic surgery, with statistically significant differences (P < 0.05), while it was not related to the menopause age, the size of tubal pregnancy mass, and the gravidity and parity, with no statistically significant differences (P > 0.05). Multivariate analysis showed that the number of abortions ≥2 and the previous pelvic surgery were the independent risk factors for REP (P < 0.05). The success rate of single-dose MTX treatment in the REP group was significantly lower than that in the PEP group (59.52% vs. 77.23%), with statistically significant difference (P < 0.05). Conclusion The number of abortions ≥2 and the history of pelvic surgery were the independent risk factors for REP. In REP cases, the success rate of single-dose MTX regimen is lower than expected, suggesting that different treatment methods should be considered in this case. |
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