【摘要】：目的探討期待治療和清宮治療中期引產(chǎn)后宮內(nèi)妊娠物殘留的預(yù)后及治療后相關(guān)并發(fā)癥的風(fēng)險(xiǎn)因素。方法回顧性收集2014 年1 月~2015 年12 月在南方醫(yī)院中期引產(chǎn)后行期待和清宮治療宮內(nèi)妊娠物殘留的270 例患者的臨床資料,采用Mann-Whitney U檢驗(yàn)和卡方檢驗(yàn)比較兩種治療方法的陰道流血時(shí)間和月經(jīng)復(fù)潮時(shí)間,建立二分類logistics回歸模型,用雙變量和多變量分析治療后相關(guān)并發(fā)癥發(fā)生的風(fēng)險(xiǎn)因素。結(jié)果期待治療組陰道流血時(shí)間顯著長(zhǎng)于清宮治療組(P=0.005),但陰道流血時(shí)間超過42 d者顯著少于清宮組(P=0.040);兩組月經(jīng)復(fù)潮時(shí)間(P=0.287)以及月經(jīng)復(fù)潮時(shí)間超過60 d者差異無統(tǒng)計(jì)學(xué)意義(P=0.783)。二分類logistics回歸分析顯示,清宮組并發(fā)癥發(fā)生風(fēng)險(xiǎn)顯著高于期待治療組(優(yōu)勢(shì)比=10.60,95%置信區(qū)間2.36~47.66,P=0.002)。在控制年齡、孕產(chǎn)次、孕周、子宮手術(shù)史、引產(chǎn)指征、引產(chǎn)方法及引產(chǎn)排胎時(shí)間等混雜因素后,清宮組并發(fā)癥發(fā)生風(fēng)險(xiǎn)仍然顯著高于期待治療組(優(yōu)勢(shì)比=18.26,95%置信區(qū)間3.57~93.42,P0.001)。結(jié)論期待治療宮內(nèi)妊娠物殘留可能會(huì)延長(zhǎng)陰道流血時(shí)間,但可減少陰道流血時(shí)間超過42 d的發(fā)生率,而且不引起明顯的治療后并發(fā)癥。
[Abstract]:Objective to investigate the prognosis and risk factors of complications related to intrauterine pregnancy after mid-term induction of labor. Methods from January 2014 to December 2015, the clinical data of 270 cases of intrauterine pregnancy residue treated by expectation and palace cleaning after induction of labor in Southern Hospital from January 2014 to December 2015 were retrospectively collected. Mann-Whitney U test and chi square test were used to compare the vaginal bleeding time and menstruation recovery time between the two treatment methods. A binary logistics regression model was established and the risk factors of related complications after treatment were analyzed by bivariate and multivariate analysis. Results the duration of vaginal bleeding in the prospective treatment group was significantly longer than that in the Qinggong treatment group (P < 0.005), but the vaginal bleeding time over 42 days in the treatment group was significantly shorter than that in the Qinggong group (P < 0.040). There was no significant difference between the two groups in menorrhagia time (P < 0. 287) and menstruation recovery time more than 60 days (P = 0. 783). The binary logistics regression analysis showed that the risk of complications in the Qinggong group was significantly higher than that in the prospective treatment group (odds ratio = 10.60, 95% confidence interval 2.36, 47.66, P < 0.002). After controlling confounding factors such as age, gestational time, gestational week, history of uterine surgery, indication of induced labor, method of induced labor and time of abortion, The risk of complications in the Qinggong group was still significantly higher than that in the prospective treatment group (odds ratio = 18.26, 95% confidence interval 3.5793.42, P0.001). Conclusion expectant treatment of intrauterine pregnancy residue may prolong vaginal bleeding time, but can reduce the incidence of vaginal bleeding more than 42 days, and does not cause obvious post-treatment complications.
【作者單位】： 南方醫(yī)科大學(xué)南方醫(yī)院婦產(chǎn)科;南方醫(yī)科大學(xué)公共衛(wèi)生學(xué)院生物統(tǒng)計(jì)學(xué)系;耶魯大學(xué)公共衛(wèi)生學(xué)院生物統(tǒng)計(jì)學(xué)系;
【分類號(hào)】：R169.42

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