[1]李 璟,光晓燕,于 琳,等.二孩政策实施前后异位妊娠临床特征的变化分析[J].医学信息,2023,36(23):13-16，29.[doi:10.3969/j.issn.1006-1959.2023.23.004]
　LI Jing,GUANG Xiao-yan,YU Lin,et al.Changes of Clinical Characteristics of Ectopic Pregnancy Before and After the Implementation of the Two-child Policy[J].Journal of Medical Information,2023,36(23):13-16，29.[doi:10.3969/j.issn.1006-1959.2023.23.004]
点击复制

二孩政策实施前后异位妊娠临床特征的变化分析()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
36卷
期数:
2023年23期
页码:
13-16，29
栏目:
医学数据科学
出版日期:
2023-12-01

文章信息/Info

Title:
Changes of Clinical Characteristics of Ectopic Pregnancy Before and After the Implementation of the Two-child Policy
文章编号:
1006-1959（2023）23-0013-05
作者:
李 璟; 光晓燕; 于 琳; 等
（1.北京大学深圳医院妇产科，广东 深圳 518036；2.深圳北京大学香港科技大学医学中心妇产科学研究所，广东 深圳 518036；3.深圳市女性重大疾病早期诊断技术重点实验室，广东 深圳 518036）
Author(s):
LI Jing; GUANG Xiao-yan; YU Lin; et al.
(1.Department of Obstetrics and Gynecology,Peking University Shenzhen Hospital,Shenzhen 518036,Guangdong,China;2.Institute of Obstetrics and Gynecology,Shenzhen PKU-HKUST Medical Center,Shenzhen 518036,Guangdong,China; 3.Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecologic Diseases,Shenzhen 518036,Guangdong,China)
关键词:
异位妊娠; 输卵管妊娠; 腹腔镜手术; 子宫瘢痕部位妊娠; 二孩政策
Keywords:
Ectopic pregnancy; Tubal pregnancy; Laparoscopic surgery; Uterine scar pregnancy; Two-child policy
分类号:
R714
DOI:
10.3969/j.issn.1006-1959.2023.23.004
文献标志码:
A
摘要:
目的 探讨二孩政策实施对异位妊娠类型、治疗方式及合并症的影响。方法 选择2009年12月-2021年5月北京大学深圳医院住院的异位妊娠患者作为研究对象。根据二孩政策实施时间2016年1月作为分界，分为政策前组和政策后组，对比两组患者中异位妊娠的类型、发病年龄、治疗方式及各类合并症的比例等临床特征。结果 共有5572例患者纳入研究，与政策前组比较，政策后组中子宫瘢痕部位妊娠的比例升高（P=0.000），≤29岁患者异位妊娠比例下降（P=0.000），而30~39岁患者异位妊娠比例升高（P=0.000），40~49岁患者异位妊娠比例无显著变化，选择腹腔镜手术的比例升高（P=0.000），选择保留输卵管手术的比例无显著变化，异位妊娠并发失血性贫血的比例下降（P=0.000），异位妊娠并发失血性休克的比例无显著变化。二孩政策实施后，异位妊娠患者合并输卵管疾病、子宫疾病、盆腔粘连、子宫内膜异位症的比例增加（P＜0.05），而合并卵巢疾病的比例无显著变化。结论 二孩政策实施后，子宫瘢痕部位妊娠的比例、异位妊娠患病年龄、腹腔镜手术治疗的比例均有增加趋势，输卵管疾病、子宫疾病、盆腔粘连、子宫内膜异位症等风险因素在异位妊娠患者中更加常见。
Abstract:
Objective To explore the effect in implementation of two-child policy in China on the types, treatment and complication of ectopic pregnancy.Methods Patients with ectopic pregnancy who were hospitalized in Peking University Shenzhen Hospital from December 2009 to May 2021 were selected as the research objects. According to the implementation time of the two-child policy in January 2016, they were divided into the pre-two-child policy group and the after-two-child policy group. The clinical characteristics of ectopic pregnancy, age of onset, treatment methods, and the proportion of various complications were compared between the two groups.Results A total of 5572 patients were included in the study. Compared with pre-two-child policy group, the proportion of uterine scar pregnancy in the after-two-child policy group increased (P=0.000), the proportion of ectopic pregnancy in patients aged ≤29 years old decreased (P=0.000), while the proportion of ectopic pregnancy in patients aged 30-39 years old increased (P=0.000), there was no significant change in the proportion of ectopic pregnancy in patients aged 40-49 years old, the proportion of laparoscopic surgery increased (P=0.000), there was no significant change in the proportion of tubal preservation surgery, the proportion of ectopic pregnancy complicated with hemorrhagic anemia decreased (P=0.000), there was no significant change in the proportion of ectopic pregnancy complicated with hemorrhagic shock. After the implementation of the two-child policy, the proportion of patients with ectopic pregnancy complicated with tubal disease, uterine disease, pelvic adhesions, and endometriosis increased (P<0.05), while there was no significant change in proportion of patients with ovarian disease.Conclusion After the implementation of the two-child policy, the proportion of uterine scar pregnancy, the age of ectopic pregnancy, and the proportion of laparoscopic surgery have an increasing trend. Risk factors such as tubal disease, uterine disease, pelvic adhesions, and endometriosis are more common in patients with ectopic pregnancy.

参考文献/References:

[1]Zeng C,Yang M,Ding Y,et al.Placenta accreta spectrum disorder trends in the context of the universal two-child policy in China and the risk of hysterectomy[J].Int J Gynaecol Obstet,2018,140(3):312-318.[2]Li HT,Xue M,Hellerstein S,et al.Association of China’s universal two child policy with changes in births and birth related health factors: national, descriptive comparative study[J].BMJ,2019,366:l4680.[3]Li Q,Deng D.New medical risks affecting obstetrics after implementation of the two-child policy in China[J].Front Med,2017,11(4):570-575.[4]杨慧霞,马京梅.重视胎盘植入的及早诊断及规范化转诊[J].中华妇产科杂志,2019,54(6):361-362.[5]杨慧霞.“二孩”时代重视妊娠并发症的预防[J].中华妇产科杂志,2018,53(4):219-220.[6]赵扬玉,原鹏波,陈练.二孩时代高龄产妇面临的问题[J].中国实用妇科与产科杂志,2020,36(2):97-100.[7]Hendriks E,Rosenberg R,Prine L.Ectopic Pregnancy:Diagnosis and Management[J].Am Fam Physician,2020,101(10):599-606.[8]钟丽燕.异位妊娠发病高危因素分析[J].实用临床医药杂志,2013,17(24):162-163.[9]张欢欢,郭艳巍,张金环,等.全面二孩政策下河北省异位妊娠患病状况的多中心研究[J].中国全科医学,2021,24(8):1017-1021.[10]陈洪琴,周容.剖宫产瘢痕部位妊娠的诊治[J].实用妇产科杂志,2018,34(1):1-3.[11]Ranji GG,Usha Rani G,Varshini S.Ectopic Pregnancy: Risk Factors, Clinical Presentation and Management[J].J Obstet Gynaecol India,2018,68(6):487-492.[12]K?觟mürcü Karuserci ?魻,Sucu S.Retrospective Evaluation of Patients Treated for Ectopic Pregnancy: Experience of a Tertiary Center[J].Rev Bras Ginecol Obstet,2020,42(12):800-804.[13]Correa-de-Araujo R,Yoon SSS.Clinical Outcomes in High-Risk Pregnancies Due to Advanced Maternal Age[J].J Womens Health (Larchmt),2021,30(2):160-167.[14]Tsakiridis I,Giouleka S,Mamopoulos A,et al.Diagnosis and Management of Ectopic Pregnancy:A Comparative Review of Major National Guidelines[J].Obstet Gynecol Surv,2020,75(10):611-623.[15]Wang X,Huang L,Yu Y,et al.Risk factors and clinical characteristics of recurrent ectopic pregnancy:A case-control study[J].J Obstet Gynaecol Res,2020,46(7):1098-1103.[16]Ellaithy M,Asiri M,Rateb A,et al.Prediction of recurrent ectopic pregnancy: A five-year follow-up cohort study[J].Eur J Obstet Gynecol Reprod Biol,2018,225:70-78.[17]Cheng X,Tian X,Yan Z,et al.Comparison of the Fertility Outcome of Salpingotomy and Salpingectomy in Women with Tubal Pregnancy: A Systematic Review and Meta-Analysis[J].PLoS One,2016,11(3):e0152343.[18]Gerema U,Alemayehu T,Chane G,et al.Determinants of ectopic pregnancy among pregnant women attending referral hospitals in southwestern part of Oromia regional state, Southwest Ethiopia: a multi-center case control study[J].BMC Pregnancy Childbirth,2021,21(1):130.

相似文献/References:

[1]胡晓华.单侧输卵管妊娠缝扎系膜血管止血保留输卵管自然受孕1例[J].医学信息,2018,31(04):190.[doi:10.3969/j.issn.1006-1959.2018.04.073]
[2]刘 爽.阴道彩超与腹部彩超诊断异位妊娠的临床价值分析[J].医学信息,2018,31(08):159.[doi:10.3969/j.issn.1006-1959.2018.08.056]
　LIU Shuang.Clinical Value of Vaginal Color Doppler Ultrasonography and Abdominal Color Doppler Ultrasound in the Diagnosis of Ectopic Pregnancy[J].Journal of Medical Information,2018,31(23):159.[doi:10.3969/j.issn.1006-1959.2018.08.056]
[3]韩玉英.腹腔镜下输卵管切开取胚联合输卵管通液术对远期妊娠的影响[J].医学信息,2018,31(21):109.[doi:10.3969/j.issn.1006-1959.2018.21.030]
　HAN Yu-ying.Effect of Embryo Extraction by Laparoscopic Oviduct Incision Combined with Hydrotubation on Long-term Pregnancy[J].Journal of Medical Information,2018,31(23):109.[doi:10.3969/j.issn.1006-1959.2018.21.030]
[4]黄 琼.阴道彩超联合血清孕酮、β-HCG及CA125对异位妊娠的诊断价值[J].医学信息,2018,31(24):128.[doi:10.3969/j.issn.1006-1959.2018.24.037]
　HUANG Qiong.Clinical Value of Vaginal Color Ultrasound Combined with Serum Progesterone,β-HCG and CA125 in the Diagnosis of Ectopic Pregnancy[J].Journal of Medical Information,2018,31(23):128.[doi:10.3969/j.issn.1006-1959.2018.24.037]
[5]韦 林,赵军玲,宾 力,等.异位妊娠腹腔镜镜像与TVS表现及 血清β-HCG表达的相关性研究[J].医学信息,2019,32(12):85.[doi:10.3969/j.issn.1006-1959.2019.12.026]
　WEI Lin,ZHAO Jun-ling,BIN Li,et al.Correlation Research between Laparoscopic Mirror Image of Ectopic Pregnancy and TVS Expression and Serum β-HCG Expression[J].Journal of Medical Information,2019,32(23):85.[doi:10.3969/j.issn.1006-1959.2019.12.026]
[6]金力荣,杨麦青,徐洪波,等.TGF-β1、HIF-1α在输卵管妊娠中的表达和意义[J].医学信息,2022,35(08):85.[doi:10.3969/j.issn.1006-1959.2022.08.020]
　JIN Li-rong,YANG Mai-qing,XU Hong-bo,et al.The Expression and Significance of TGF-β1, HIF-1α in Tubal Pregnancy[J].Journal of Medical Information,2022,35(23):85.[doi:10.3969/j.issn.1006-1959.2022.08.020]
[7]金力荣,杨麦青,徐洪波,等.TGF-β1、MMP-9、VEGF在输卵管妊娠中的表达和意义[J].医学信息,2022,35(12):122.[doi:10.3969/j.issn.1006-1959.2022.12.029]
　JIN Li-rong,YANG Mai-qing,XU Hong-bo,et al.The Expression and Significance of TGF-β1, MMP-9, VEGF in Tubal Pregnancy[J].Journal of Medical Information,2022,35(23):122.[doi:10.3969/j.issn.1006-1959.2022.12.029]
[8]徐小芳.经阴道超声检查对异位妊娠的诊断价值分析[J].医学信息,2022,35(18):144.[doi:10.3969/j.issn.1006-1959.2022.18.040]
　XU Xiao-fang.Diagnostic Value of Transvaginal Ultrasonography in Ectopic Pregnancy[J].Journal of Medical Information,2022,35(23):144.[doi:10.3969/j.issn.1006-1959.2022.18.040]
[9]叶瑛瑛,王金辉,谢灵平.miRNA-323-3p联合miRNA-873在异位妊娠早期诊断中的价值研究[J].医学信息,2022,35(22):72.[doi:10.3969/j.issn.1006-1959.2022.22.012]
　YE Ying-ying,WANG Jin-hui,XIE Ling-ping.The Value of miRNA-323-3p Combined with miRNA-873 in Early Diagnosis of Ectopic Pregnancy[J].Journal of Medical Information,2022,35(23):72.[doi:10.3969/j.issn.1006-1959.2022.22.012]
[10]林 华,郑 珺.阴道彩超在异位妊娠早期筛查中的声像特征及诊断效能分析[J].医学信息,2022,35(22):145.[doi:10.3969/j.issn.1006-1959.2022.22.035]
　LIN Hua,ZHENG Jun.Ultrasonographic Features and Diagnostic Efficiency of Transvaginal Ultrasonography in Early Screening of Ectopic Pregnancy[J].Journal of Medical Information,2022,35(23):145.[doi:10.3969/j.issn.1006-1959.2022.22.035]

更新日期/Last Update: 1900-01-01