国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2012, Vol. 31 ›› Issue (2): 97-98.

• 论著 • 上一篇    下一篇

体外受精-胚胎移植后异位妊娠相关危险因素的研究

杜爱军,张印峰,张云山,罗海宁,徐凤琴   

  1. 300100天津市中心妇产科医院
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2012-03-15 发布日期:2012-03-15
  • 通讯作者: 张云山

DU Ai-jun，ZHANG Yin-feng，ZHANG Yun -shan，LUO Hai -ning， XU Feng -qin   

  1. ianjin Central Hospital of Gynecology and Obstetrics，Tianjin 300100，China
  • Received:1900-01-01 Revised:1900-01-01 Published:2012-03-15 Online:2012-03-15
  • Contact: ZHANG Yun -shan

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摘要： 目的：探讨取卵周期体外受精-胚胎移植（IVF-ET）后异位妊娠（ EP）的危险因素。方法：选
择2005年1月—2010年12月行IVF-ET治疗后 EP患者122例（占同期行 IVF-ET治疗1 850例患者的 6.6%），其
中包括宫内外同时妊娠（ HP）患者11例，为观察组；在同期IVF-ET后获宫内临床妊娠1 728例患者中随机抽
取450例为对照组。比较2组间盆腔输卵管病变、子宫内膜异位症（ EMs）及EMs术后、卵巢病变、月经稀发所
占比例及一般临床特征的区别。结果：多因素Logistic回归分析结果表明，盆腔输卵管病变（茁=0.705，
OR=2.023）、EMs及EMs术后（茁=1.393，OR=4.025）、内膜（En）厚度≤7 mm（茁=1.695，OR=5.446）是IVF-ET中
异位妊娠发生的危险因素。结论：对具有以上危险因素的 EP患者，在行IVF-ET治疗前尽量减少危险因素
的存在，如存在盆腔输卵管因素可以对部分患者进行输卵管近端结扎或者切除；在患者妊娠后，为防止异
位妊娠灶破裂，应根据血清人绒毛膜促性腺激素（hCG）值适当提前行阴道超声检测的时间（IVF-ET后一
般进行阴道超声检测的时间为胚胎移植后28d）和适当增加前期超声检测的次数，及时做到早发现、早预
防、早治疗尤为重要。

关键词: 受精, 体外, 胚胎移植, 妊娠, 异位, 危险因素, 妊娠并发症

Abstract: Objective：To explore the risk factors of ectopic pregnancy after in vitro fertilization and embryo transfer（IVF-ET）. Methods：122 cases of ectopic pregnancy in1 850 cases after IVF-ET treatment
（6.6%）were selected between 2005, Jan. and 2010, Dec. in Center of Reproductive Medicine，Tianjin Central Hospital of Gynecology and Obstetrics，including 11 cases of Heterotopic pregnancy, as the observation group.450 cases were randomly selected from 1 728 cases of intrauterine pregnancy after IVF-ET as control. Pelvicoviduct factors、endometriosis and endometriosis postsurgery factors、ovary diseases、hypomenorrhea, general clinical features were compared between two groups. Results：The ectopic pregnancy rate was significantly increased in those patients with pelvic oviduct factors，endometriosis and endometriosis postsurgery factors， endometrial thickness臆7 mm. Conclusions：For those patients who have above mentioned risk factors，those risk factors should be controlled to the greatest extent when they received IVF-ET treatment. For those patientswho have potential EP, early discovery and diagnosis such as sera hCG level tests and B ultrasounds atreasonable times, and early treatment, are important for them to prevent ectopic pregnancy rupture.

Key words: Fertilization in vitro, Embryo transfer, Pregnancy, ectopic, Risk factors, Pregnancy complications