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《中国医学前沿杂志（电子版）》2019年第11卷第4期
DOI：10.12037/YXQY.2019.04-16
辅助生殖技术后发生异位妊娠的危险因素分析
何桦1，陈昀1，杨小杰2（1．唐山市妇幼保健院 超声医学科，河北 唐山 063000；2．唐山市妇幼保健院 妇产科，河北 唐山 063000）
【摘要】 目的 探讨实施辅助生殖技术（assisted reproductive technology，ART）后发生异位妊娠的危险因素，并提出相关干预措施。方法 选取2014年6月至2017年9月在本院行ART后发生异位妊娠的患者82例纳入异位妊娠组，同期成功宫内妊娠的孕妇106例纳入宫内妊娠组，比较两组孕妇的临床资料，应用单因素及多因素Logistic回归分析探讨ART后异位妊娠发生的危险因素。结果 两组孕妇不孕年限、原发不孕、男方因素、体质指数、移植胚胎个数、染色体异常比较均无明显差异（P均＞0.05），而盆腔手术史、既往异位妊娠史、移植时子宫内膜厚度、排卵障碍、输卵管因素及子宫内膜异位症比较均有明显差异（P均＜0.05）；多因素Logistic回归分析显示，盆腔手术史、移植时子宫内膜厚度、既往异位妊娠史、子宫内膜异位症、排卵障碍及输卵管因素均是ART后发生异位妊娠的独立危险因素（P均＜0.05）。结论 在行ART前应对患者存在的危险因素进行详细评估，以降低ART后异位妊娠的发生率，改善妊娠结局。【关键词】 辅助生殖技术；异位妊娠；危险因素；干预措施
Analysis of the risk factors for ectopic pregnancy after assisted reproductive technology
HE Hua1, CHEN Yun1, YANG Xiao-jie2 (1. Department of Ultrasound Medicine, Tangshan Maternal and Child Health Hospital, Hebei, Tangshan 063000, China; 2. Department of Gynaecology and Obstetrics, Tangshan Maternal and Child Health Hospital, Hebei, Tangshan 063000, China)
Corresponding author:YANG Xiao-jie, E-mail: Dbk915@sina.com【Abstract】 Objective To explore the risk factors for ectopic pregnancy after assisted reproductive technology (ART) and propose relevant interventions. Method From June 2014 to September 2017, 82 patients with ectopic pregnancy after implementation of ART in our hospital were included in ectopic pregnancy group, and 106 patients with successful intrauterine pregnancy were included in intrauterine pregnancy group. The clinical data of the two groups were compared, and the risk factors of ectopic pregnancy were investigated by single factor and multivariate Logistic regression analysis. Result There were no signi?cant di?erences in infertility years, primary infertility, male factors, body mass index, number of transplanted embryos, and chromosomal abnormalities between the two groups (Pall＞0.05). The history of pelvic surgery, previous history of ectopic pregnancy, endometrial thickness during transplantation, ovulation disorders, tubal factors and endometriosis comparison were signi?cantly di?erent (Pall＜0.05). Multivariate Logistic regression analysis showed that history of pelvic surgery, endometrial thickness during transplantation, history of ectopic pregnancy, endometriosis, ovulation disorders and tubal factors were independent risk factors for ectopic pregnancy after ART (Pall＜0.05). Conclusion The risk factors should be evaluated in detail before the implementation of ART to reduce the incidence of ectopic pregnancy and improve pregnancy outcomes.【Key words】 Assisted reproductive technology; Ectopic pregnancy; Risk factors; Intervention measures
近年来，随着辅助生殖技术（assisted reprod-uctive technology，ART）在临床上的广泛应用，其并发症——异位妊娠的发生率也呈逐年上升趋势[1-3]。异位妊娠是临床常见的妇科急腹症，可导致女性永久性不孕，甚至危及患者生命。异位妊娠在自然妊娠中的发生率为1.%～2.0%，实施ART后的发生
率为2.1%～8.6%，明显高于自然妊娠[4]。目前，行ART后发生异位妊娠的机制尚不明确，可能与超生理的激素环境、输卵管因素（包括输卵管内环境异常、输卵管运输胚胎功能受损等）、胚胎自身因素、胚胎发育潜能及ART操作等因素有关[5]。为进一步探讨行ART后发生异位妊娠的危险因素，本研究分
基金项目：河北省2018年度医学科学研究重点课题计划（20181336）
通讯作者：杨小杰 E-mail：Dbk915@sina.com
辅助生殖技术后发生异位妊娠的危险因素分析
