Article(id=1208154040412778856, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1208154038609228128, articleNumber=null, orderNo=null, doi=10.11855/j.issn.0577-7402.2022.02.0157, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=research-article, receivedDate=1629907200000, receivedDateStr=2021-08-26, revisedDate=null, revisedDateStr=null, acceptedDate=1640793600000, acceptedDateStr=2021-12-30, onlineDate=1765975969651, onlineDateStr=2025-12-17, pubDate=1645977600000, pubDateStr=2022-02-28, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1765975969651, onlineIssueDateStr=2025-12-17, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1765975969651, creator=13701087609, updateTime=1765975969651, updator=13701087609, issue=Issue{id=1208154038609228128, tenantId=1146029695717560320, journalId=1189873630562394117, year='2022', volume='47', issue='2', pageStart='107', pageEnd='212', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1765975969218, creator=13701087609, updateTime=1765976148463, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1208154790459192257, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1208154038609228128, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1208154790459192258, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1208154038609228128, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=157, endPage=161, ext={EN=ArticleExt(id=1208154041134199150, articleId=1208154040412778856, tenantId=1146029695717560320, journalId=1189873630562394117, language=EN, title=Risk factors of persistent ectopic pregnancy after tubal pregnancy surgery, columnId=1190310109000602400, journalTitle=Medical Journal of Chinese People’s Liberation Army, columnName=Clinical Research, runingTitle=null, highlight=null, articleAbstract=

Objective To explore the risk factors of persistent ectopic pregnancy (PEP) in patients with fallopian tubal pregnancy after tubal pregnancy surgery. Methods A total of 38 patients, who underwent the tubal pregnancy surgery in International Peace Maternity and Child Health Hospital affiliated to Medical College of Shanghai Jiao Tong University from January 2000 to December 2020, were selected as the research subjects and included into PEP group; and another 152 patients undergone the same operation during the same period and recovered well were selected as control group. The clinical data of the two groups were analyzed retrospectively. The age, gravidity, body mass index (BMI), menopause duration, previous fallopian tube surgery history, postoperative serum β-human chorionic gonadotropin (β-HCG) decline rate, tubal pregnancy site, ectopic pregnancy focus, and intraoperative pelvic adhesion etc. of all patients were recorded and analyzed. The clinical baseline data of the two groups were analyzed. The chi square test was used to analyze the risk factors of PEP after tubal pregnancy surgery, and Poisson regression analysis was performed to do the multivariate analysis. The independent risk factors of PEP after tubal pregnancy surgery were screened, and then the treatment method of PEP after tubal pregnancy surgery was analyzed. Results There were no significant differences between PEP group and control group in terms of age, gravidity, BMI and menopause duration. Univariate analysis showed that the PEP after tubal pregnancy surgery was related to emergency/elective surgery, pelvic adhesion and the rupture of ectopic pregnancy lesions/abortion, and the difference was statistically significant (P<0.05), while no obvious relation to the operation method, the location of tubal pregnancy and the size of ectopic pregnancy focus. Poisson regression analysis showed that the pelvic adhesion and the rupture of ectopic pregnancy lesions/abortion were the independent risk factors of PEP. The cure rates with methotrexate (MTX) treatment was 95% for PEP patient after tubal pregnancy surgery. Conclusion The pelvic adhesion and the rupture of ectopic pregnancy lesions/abortion were the independent risk factors of PEP after the tubal pregnancy surgery.

, correspAuthors=Si-Qin Yang, authorNote=null, correspAuthorsNote=
*E-mail:
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目的 探讨输卵管妊娠患者术后发生持续性异位妊娠(PEP)的危险因素。方法 选取2000年1月-2020年12月在上海交通大学医学院附属国际和平妇幼保健院接受输卵管妊娠手术且术后发生PEP的38例患者为PEP组,同时选择同期行相同手术且手术成功、术后恢复良好的152例患者为对照组。回顾性分析两组患者的临床资料,记录并分析比较所有患者的年龄、孕次、体重指数(BMI)、停经时间、既往输卵管手术史、术后血清β-人绒毛膜促性腺激素(β-hCG)下降率、输卵管妊娠部位、异位妊娠病灶情况、术中盆腔粘连情况等。分析两组的临床基线资料,采用χ2检验进行输卵管妊娠术后PEP危险因素的单因素分析,采用Poisson回归进行多因素分析,筛选输卵管妊娠术后PEP的独立危险因素,并分析输卵管妊娠术后PEP的治疗方法等。结果 PEP组的年龄、孕次、BMI、停经时间等与对照组比较差异均无统计学意义(P>0.05)。单因素分析结果显示,输卵管妊娠手术后PEP的发生与急诊/择期手术、盆腔粘连、输卵管妊娠病灶破裂/流产有关,差异有统计学意义(P<0.05),而与手术方式、输卵管妊娠部位、输卵管妊娠病灶大小等无明显相关。Poisson回归分析结果显示,盆腔粘连、输卵管妊娠病灶破裂/流产是输卵管妊娠术后发生PEP的独立危险因素。输卵管妊娠患者手术后发生PEP的患者95%可经药物治疗成功。结论 盆腔粘连、输卵管妊娠病灶破裂/流产是输卵管妊娠术后发生PEP的独立危险因素。

, correspAuthors=杨思勤, authorNote=null, correspAuthorsNote=
杨思勤,E-mail:
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于津,医学硕士,主治医师,主要从事妇科临床方面的研究

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pageEnd=18, url=null, language=null, rfNumber=[1], rfOrder=0, authorNames=Chong KY, Mak YK, Vollenhoven B, journalName=Fertil Reprod, refType=null, unstructuredReference=Chong KY, Mak YK, Vollenhoven B, et al. An audit of management of ectopic pregnancy in a major tertiary healthcare service[J]. Fertil Reprod, 2021, 3(1): 14-18., articleTitle=An audit of management of ectopic pregnancy in a major tertiary healthcare service, refAbstract=null), Reference(id=1208154045328503360, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208154040412778856, doi=null, pmid=null, pmcid=null, year=2019, volume=367, issue=null, pageStart=l6283, pageEnd=null, url=null, language=null, rfNumber=[2], rfOrder=1, authorNames=Webster K, Eadon H, Fishburn S, journalName=BMJ, refType=null, unstructuredReference=Webster K, Eadon H, Fishburn S, et al. Ectopic pregnancy and miscarriage: diagnosis and initial management: summary of updated NICE guidance[J]. BMJ, 2019, 367: l6283., articleTitle=Ectopic pregnancy and miscarriage: diagnosis and initial management: summary of updated NICE guidance, refAbstract=null), Reference(id=1208154045458526792, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208154040412778856, doi=null, pmid=null, pmcid=null, year=2018, volume=15, issue=6, pageStart=194, pageEnd=197, url=null, language=null, rfNumber=[3], rfOrder=2, authorNames=Fan SD, Huang XD, Xiao C, journalName=Pract J Clin Med, refType=null, unstructuredReference=Fan SD, Huang XD, Xiao C, et al. Salpingotomy versus salpingectomy for the treatment of tubal ectopic pregnancy: a meta-analysis[J]. Pract J Clin Med, 2018, 15(6): 194-197., articleTitle=Salpingotomy versus salpingectomy for the treatment of tubal ectopic pregnancy: a meta-analysis, refAbstract=null), Reference(id=1208154045559190096, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208154040412778856, doi=null, pmid=null, pmcid=null, year=2018, volume=15, issue=6, pageStart=194, pageEnd=197, url=null, language=null, rfNumber=[3], rfOrder=3, authorNames=范蜀东, 黄学丹, 肖超, journalName=实用医院临床杂志, refType=null, unstructuredReference=[范蜀东, 黄学丹, 肖超. 输卵管切除与输卵管开窗取胚术输卵管妊娠的Meta分析[J]. 实用医院临床杂志, 2018, 15(6): 194-197.], articleTitle=输卵管切除与输卵管开窗取胚术输卵管妊娠的Meta分析, refAbstract=null), Reference(id=1208154045655659096, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208154040412778856, doi=null, pmid=null, pmcid=null, year=1999, volume=42, issue=1, pageStart=9, pageEnd=22, url=null, language=null, rfNumber=[4], rfOrder=4, authorNames=Graczykowski JW, Seifer DB, journalName=Clin Obstet Gynecol, refType=null, unstructuredReference=Graczykowski JW, Seifer DB. Diagnosis of acute and persistent ectopic pregnancy[J]. Clin Obstet Gynecol, 1999, 42(1): 9-22., articleTitle=Diagnosis of acute and persistent ectopic pregnancy, refAbstract=null), Reference(id=1208154045735350874, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208154040412778856, doi=null, pmid=null, pmcid=null, year=2019, volume=26, issue=6, pageStart=1036, pageEnd=1043, url=null, language=null, rfNumber=[5], rfOrder=5, authorNames=Ting WH, Lin HH, Hsiao SM, journalName=J Minim Invasive Gynecol, refType=null, unstructuredReference=Ting WH, Lin HH, Hsiao SM. Factors predicting persistent ectopic pregnancy after laparoscopic salpingostomy or salpingotomy for tubal pregnancy: a retrospective cohort study[J]. J Minim Invasive Gynecol, 2019, 26(6): 1036-1043., articleTitle=Factors predicting persistent ectopic pregnancy after laparoscopic salpingostomy or salpingotomy for tubal pregnancy: a retrospective cohort study, refAbstract=null), Reference(id=1208154045836014180, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208154040412778856, doi=null, pmid=null, pmcid=null, year=2020, volume=100, issue=14, pageStart=1077, pageEnd=1080, url=null, language=null, rfNumber=[6], rfOrder=6, authorNames=Jin QY, Jin XY, Zhang SY, journalName=Natl Med J China, refType=null, unstructuredReference=Jin QY, Jin XY, Zhang SY. The clinical efficacy of laparoscopic cornuotomy on interstitial tubal pregnancy which diameter was shorter than 3 cm[J]. Natl Med J China, 2020, 100(14): 1077-1080., articleTitle=The clinical efficacy of laparoscopic cornuotomy on interstitial tubal pregnancy which diameter was shorter than 3 cm, refAbstract=null), Reference(id=1208154045949260396, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208154040412778856, doi=null, pmid=null, pmcid=null, year=2020, volume=null, issue=14, pageStart=1077, pageEnd=1080, url=null, language=null, rfNumber=[6], rfOrder=7, authorNames=金倩燕, 金小英, 张松英, journalName=中华医学杂志, refType=null, unstructuredReference=[金倩燕, 金小英, 张松英. 腹腔镜下切开取胚术治疗直径小于3 cm输卵管间质部妊娠的效果分析[J]. 中华医学杂志, 2020, 100(14): 1077-1080.], articleTitle=腹腔镜下切开取胚术治疗直径小于3 cm输卵管间质部妊娠的效果分析, refAbstract=null), Reference(id=1208154046058312305, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208154040412778856, doi=null, pmid=null, pmcid=null, year=2015, volume=81, issue=11, pageStart=1053, pageEnd=1059, url=null, language=null, rfNumber=[7], rfOrder=8, authorNames=Lund CO, Nilas L, Bangsgaard N, journalName=Acta Obstet Gynecol Scand, refType=null, unstructuredReference=Lund CO, Nilas L, Bangsgaard N, et al. Persistent ectopic pregnancy after linear salpingotomy: a non-predictable complication to conservative surgery for tubal gestation[J]. Acta Obstet Gynecol Scand, 2015, 81(11): 1053-1059., articleTitle=Persistent ectopic pregnancy after linear salpingotomy: a non-predictable complication to conservative surgery for tubal gestation, refAbstract=null), Reference(id=1208154046154781303, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208154040412778856, doi=null, pmid=null, pmcid=null, year=2017, volume=43, issue=3, pageStart=564, pageEnd=570, url=null, language=null, rfNumber=[8], rfOrder=9, authorNames=Zhang Y, Chen J, Lu W, journalName=J Obstet Gynaecol Res, refType=null, unstructuredReference=Zhang Y, Chen J, Lu W, et al. Clinical characteristics of persistent ectopic pregnancy after salpingostomy and influence on ongoing pregnancy[J]. J Obstet Gynaecol Res, 2017, 43(3): 564-570., articleTitle=Clinical characteristics of persistent ectopic pregnancy after salpingostomy and influence on ongoing pregnancy, refAbstract=null), Reference(id=1208154046247055996, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208154040412778856, doi=null, pmid=null, pmcid=null, year=2016, volume=16, issue=8, pageStart=677, pageEnd=680, url=null, language=null, rfNumber=[9], rfOrder=10, authorNames=Song JH, Wang KF, Zhang J, journalName=Chin J Minim Inva Surg, refType=null, unstructuredReference=Song JH, Wang KF, Zhang J, et al. Multivariate analysis on persistent ectopic pregnancy after laparoscopic conservative surgery for tubal pregnancy[J]. Chin J Minim Inva Surg, 2016, 16(8): 677-680., articleTitle=Multivariate analysis on persistent ectopic pregnancy after laparoscopic conservative surgery for tubal pregnancy, refAbstract=null), Reference(id=1208154046360302211, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208154040412778856, doi=null, pmid=null, pmcid=null, year=2016, volume=16, issue=8, pageStart=677, pageEnd=680, url=null, language=null, rfNumber=[9], rfOrder=11, authorNames=宋菁华, 王克芳, 张军, journalName=中国微创外科杂志, refType=null, unstructuredReference=[宋菁华, 王克芳, 张军, 等. 腹腔镜输卵管妊娠保守性手术后发生持续性异位妊娠的多因素分析[J]. 中国微创外科杂志, 2016, 16(8): 677-680.], articleTitle=腹腔镜输卵管妊娠保守性手术后发生持续性异位妊娠的多因素分析, refAbstract=null), Reference(id=1208154046477742726, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208154040412778856, doi=null, pmid=null, pmcid=null, year=2014, volume=40, issue=2, pageStart=453, pageEnd=458, url=null, language=null, rfNumber=[10], rfOrder=12, authorNames=Kayatas S, Demirci O, Kumru P, journalName=J Obstet Gynaecol Res, refType=null, unstructuredReference=Kayatas S, Demirci O, Kumru P, et al. Predictive factors for failure of salpingostomy in ectopic pregnancy[J]. J Obstet Gynaecol Res, 2014, 40(2): 453-458., articleTitle=Predictive factors for failure of salpingostomy in ectopic pregnancy, refAbstract=null), Reference(id=1208154046586794634, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208154040412778856, doi=null, pmid=null, pmcid=null, year=2019, volume=12, issue=3, pageStart=901, pageEnd=908, url=null, language=null, rfNumber=[11], rfOrder=13, authorNames=Li X, Zhang C, Li Y, journalName=Int J Clin Exp Pathol, refType=null, unstructuredReference=Li X, Zhang C, Li Y, et al. Predictive values of the ratio of beta-human chorionic gonadotropin for failure of salpingostomy in ectopic pregnancy[J]. Int J Clin Exp Pathol, 2019, 12(3): 901-908., articleTitle=Predictive values of the ratio of beta-human chorionic gonadotropin for failure of salpingostomy in ectopic pregnancy, refAbstract=null), Reference(id=1208154046683263633, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208154040412778856, doi=null, pmid=null, pmcid=null, year=2017, volume=35, issue=48 Pt A, pageStart=6563, pageEnd=6574, url=null, language=null, rfNumber=[12], rfOrder=14, authorNames=Rouse CE, Eckert LO, Babarinsa I, journalName=Vaccine, refType=null, unstructuredReference=Rouse CE, Eckert LO, Babarinsa I, et al. Spontaneous abortion and ectopic pregnancy: case definition & guidelines for data collection, analysis, and presentation of maternal immunization safety data[J]. Vaccine, 2017, 35(48 Pt A): 6563-6574., articleTitle=Spontaneous abortion and ectopic pregnancy: case definition & guidelines for data collection, analysis, and presentation of maternal immunization safety data, refAbstract=null), Reference(id=1208154046775538325, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208154040412778856, doi=null, pmid=null, pmcid=null, year=2020, volume=33, issue=10, pageStart=1908, pageEnd=1910, url=null, language=null, rfNumber=[13], rfOrder=15, authorNames=LeMaistre A, Bracey A, Katz A, journalName=Clin Chem, refType=null, unstructuredReference=LeMaistre A, Bracey A, Katz A, et al. Role of qualitative choriogonadotropin assays in diagnosis of ectopic pregnancy[J]. Clin Chem, 2020, 33(10): 1908-1910., articleTitle=Role of qualitative choriogonadotropin assays in diagnosis of ectopic pregnancy, refAbstract=null), Reference(id=1208154046851035800, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208154040412778856, doi=null, pmid=null, pmcid=null, year=2017, volume=8, issue=9, pageStart=14570, pageEnd=14575, url=null, language=null, rfNumber=[14], rfOrder=16, authorNames=Lin S, Yang R, Chi H, journalName=Oncotarget, refType=null, unstructuredReference=Lin S, Yang R, Chi H, et al. Increased incidence of ectopic pregnancy after in vitro fertilization in women with decreased ovarian reserve[J]. Oncotarget, 2017, 8(9): 14570-14575., articleTitle=Increased incidence of ectopic pregnancy after in vitro fertilization in women with decreased ovarian reserve, refAbstract=null), Reference(id=1208154046943310494, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208154040412778856, doi=null, pmid=null, pmcid=null, year=2014, volume=383, issue=9927, pageStart=1483, pageEnd=1489, url=null, language=null, rfNumber=[15], rfOrder=17, authorNames=Mol F, van Mello NM, Strandell A, journalName=Lancet, refType=null, unstructuredReference=Mol F, van Mello NM, Strandell A, et al. Salpingotomy versus salpingectomy in women with tubal pregnancy (ESEP study): an open-label, multicentre, randomised controlled trial[J]. Lancet, 2014, 383(9927): 1483-1489., articleTitle=Salpingotomy versus salpingectomy in women with tubal pregnancy (ESEP study): an open-label, multicentre, randomised controlled trial, refAbstract=null), Reference(id=1208154047043973798, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208154040412778856, doi=null, pmid=null, pmcid=null, year=2013, volume=28, issue=5, pageStart=1247, pageEnd=1253, url=null, language=null, rfNumber=[16], rfOrder=18, authorNames=Fernandez H, Capmas P, Lucot JP, journalName=Hum Reprod, refType=null, unstructuredReference=Fernandez H, Capmas P, Lucot JP, et al. Fertility after ectopic pregnancy: the DEMETER randomized trial[J]. Hum Reprod, 2013, 28(5): 1247-1253., articleTitle=Fertility after ectopic pregnancy: the DEMETER randomized trial, refAbstract=null), Reference(id=1208154047123665580, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208154040412778856, doi=null, pmid=null, pmcid=null, year=2001, volume=108, issue=2, pageStart=192, pageEnd=203, url=null, language=null, rfNumber=[17], rfOrder=19, authorNames=Sowter MC, Farquhar CM, Petrie KJ, journalName=BJOG, refType=null, unstructuredReference=Sowter MC, Farquhar CM, Petrie KJ, et al. A randomised trial comparing single dose systemic methotrexate and laparoscopic surgery for the treatment of unruptured tubal pregnancy[J]. BJOG, 2001, 108(2): 192-203., articleTitle=A randomised trial comparing single dose systemic methotrexate and laparoscopic surgery for the treatment of unruptured tubal pregnancy, refAbstract=null)], funds=[Fund(id=1208154044829381164, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208154040412778856, awardId=YG2019QNA08, language=EN, fundingSource=Medical Engineering Cross Project of Shanghai Jiao Tong University(YG2019QNA08), fundOrder=null, country=null), Fund(id=1208154045118788147, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208154040412778856, awardId=YG2019QNA08, language=CN, fundingSource=上海交通大学医工交叉项目(YG2019QNA08), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1208154042535096708, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208154040412778856, xref=null, ext=[AuthorCompanyExt(id=1208154042543485318, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208154040412778856, companyId=1208154042535096708, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Obstetrics and Gynecology, the International Peace Maternal and Child Health Hospital, Shanghai Jiao Tong University School of Medicine/Shanghai Key Laboratory of Embryo Original Disease, Shanghai Municipal Key Clinical Specialty, Shanghai 200030, China), AuthorCompanyExt(id=1208154042564456841, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208154040412778856, companyId=1208154042535096708, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=上海交通大学医学院附属国际和平妇幼保健院妇产科/上海市胚胎源性疾病重点实验室/上海市临床重点专科建设—“强主体”妇产科,上海 200030)])], figs=[ArticleFig(id=1208154044057629157, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208154040412778856, language=EN, label=Tab.1, caption=

Comparison of general clinical data of patients undergone tubal pregnancy surgery between the two groups

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项目PEP组对照组t/ZP
年龄(岁,$\bar{x}±s$)29.2±4.629.1±5.20.5880.278
孕次[次,M(Q1, Q3]2.0(1.0,4.0)2.0(1.0,3.0)1.5730.116
BMI(kg/m2,$\bar{x}±s$)22.4±2.323.1±2.60.9280.555
停经时间(d,$\bar{x}±s$)47.5±7.346.2±6.70.2990.821
), ArticleFig(id=1208154044158292463, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208154040412778856, language=CN, label=表1, caption=

两组输卵管妊娠手术患者一般临床资料比较

, figureFileSmall=null, figureFileBig=null, tableContent=
项目PEP组对照组t/ZP
年龄(岁,$\bar{x}±s$)29.2±4.629.1±5.20.5880.278
孕次[次,M(Q1, Q3]2.0(1.0,4.0)2.0(1.0,3.0)1.5730.116
BMI(kg/m2,$\bar{x}±s$)22.4±2.323.1±2.60.9280.555
停经时间(d,$\bar{x}±s$)47.5±7.346.2±6.70.2990.821
), ArticleFig(id=1208154044233789944, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208154040412778856, language=EN, label=Tab.2, caption=

Univariate analysis of persistent ectopic pregnancy after tubal pregnancy surgery [n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
危险因素PEP组对照组χ2/tP
停经时间  1.03>0.05
 <42 d5(13.2)12(8.0)
 ≥42 d33(86.8)140(90.0)
异位妊娠病灶直径  2.94>0.05
 <3 cm10(26.3)63(41.5)
 ≥3 cm28(73.7)89(58.5)
盆腹腔积血量(ml,$\bar{x}±s$)453±20.9389±37.511.70>0.05
手术方式  0.20>0.05
 根治性手术15(39.5)54(35.6)
 保守性手术23(60.5)98(64.5)
血清β-hCG水平  13.92>0.05
 <2000 U/L12(31.6)68(44.7)
 ≥2000 U/L26(68.4)84(55.3)
输卵管妊娠病灶部位  21.27>0.05
 输卵管间质部3(7.9)1(0.7)
 输卵管峡部5(13.2)3(2.0)
 输卵管壶腹部25(65.8)148(97.3)
 输卵管伞端2(5.3)0(0)
 不确定3(7.9)0(0)
异位妊娠病灶破裂/流产  98.41<0.05
 33(86.8)14(9.2)
 5(13.2)138(90.8)
盆腔粘连  24.42<0.05
 20(52.6)23(15.1)
 18(47.4)129(84.9)
急诊/择期手术  28.50<0.05
 急诊手术20(52.6)20(13.2)
 择期手术18(47.4)132(86.8)
手术路径  7.43>0.05
 开腹8(21.1)10(6.6)
 腹腔镜30(78.9)142(93.4)
既往异位妊娠史  1.60>0.05
 3(7.9)5(3.3)
 35(92.1)147(96.7)
既往盆腔手术史  0.31>0.05
 6(15.8)30(19.7)
 32(84.2)122(80.3)  
), ArticleFig(id=1208154044347036162, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208154040412778856, language=CN, label=表2, caption=

输卵管妊娠术后持续性异位妊娠(PEP)危险因素的单因素分析[例(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
危险因素PEP组对照组χ2/tP
停经时间  1.03>0.05
 <42 d5(13.2)12(8.0)
 ≥42 d33(86.8)140(90.0)
异位妊娠病灶直径  2.94>0.05
 <3 cm10(26.3)63(41.5)
 ≥3 cm28(73.7)89(58.5)
盆腹腔积血量(ml,$\bar{x}±s$)453±20.9389±37.511.70>0.05
手术方式  0.20>0.05
 根治性手术15(39.5)54(35.6)
 保守性手术23(60.5)98(64.5)
血清β-hCG水平  13.92>0.05
 <2000 U/L12(31.6)68(44.7)
 ≥2000 U/L26(68.4)84(55.3)
输卵管妊娠病灶部位  21.27>0.05
 输卵管间质部3(7.9)1(0.7)
 输卵管峡部5(13.2)3(2.0)
 输卵管壶腹部25(65.8)148(97.3)
 输卵管伞端2(5.3)0(0)
 不确定3(7.9)0(0)
异位妊娠病灶破裂/流产  98.41<0.05
 33(86.8)14(9.2)
 5(13.2)138(90.8)
盆腔粘连  24.42<0.05
 20(52.6)23(15.1)
 18(47.4)129(84.9)
急诊/择期手术  28.50<0.05
 急诊手术20(52.6)20(13.2)
 择期手术18(47.4)132(86.8)
手术路径  7.43>0.05
 开腹8(21.1)10(6.6)
 腹腔镜30(78.9)142(93.4)
既往异位妊娠史  1.60>0.05
 3(7.9)5(3.3)
 35(92.1)147(96.7)
既往盆腔手术史  0.31>0.05
 6(15.8)30(19.7)
 32(84.2)122(80.3)  
), ArticleFig(id=1208154044594500117, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208154040412778856, language=EN, label=Tab.3, caption=

Poisson regression analysis of persistent ectopic pregnancy after tubal pregnancy surgery

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危险因素βSEEXP(β)95%CIWald χ2P
盆腔粘连0.0030.0091.0291.010~1.0498.985<0.05
异位妊娠病灶破裂/流产0.0120.0291.0761.016~1.1386.326<0.05
), ArticleFig(id=1208154044716134943, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208154040412778856, language=CN, label=表3, caption=

输卵管妊娠术后持续性异位妊娠(PEP)危险因素的Poisson回归分析结果

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危险因素βSEEXP(β)95%CIWald χ2P
盆腔粘连0.0030.0091.0291.010~1.0498.985<0.05
异位妊娠病灶破裂/流产0.0120.0291.0761.016~1.1386.326<0.05
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输卵管妊娠术后持续性异位妊娠的危险因素分析
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于津 , 杨思勤 *
解放军医学杂志 | 临床研究 2022,47(2): 157-161
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解放军医学杂志 | 临床研究 2022, 47(2): 157-161
输卵管妊娠术后持续性异位妊娠的危险因素分析
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于津, 杨思勤*
作者信息
  • 上海交通大学医学院附属国际和平妇幼保健院妇产科/上海市胚胎源性疾病重点实验室/上海市临床重点专科建设—“强主体”妇产科,上海 200030
  • 于津,医学硕士,主治医师,主要从事妇科临床方面的研究

通讯作者:

杨思勤,E-mail:
Risk factors of persistent ectopic pregnancy after tubal pregnancy surgery
Jin Yu, Si-Qin Yang*
Affiliations
  • Department of Obstetrics and Gynecology, the International Peace Maternal and Child Health Hospital, Shanghai Jiao Tong University School of Medicine/Shanghai Key Laboratory of Embryo Original Disease, Shanghai Municipal Key Clinical Specialty, Shanghai 200030, China
出版时间: 2022-02-28 doi: 10.11855/j.issn.0577-7402.2022.02.0157
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目的 探讨输卵管妊娠患者术后发生持续性异位妊娠(PEP)的危险因素。方法 选取2000年1月-2020年12月在上海交通大学医学院附属国际和平妇幼保健院接受输卵管妊娠手术且术后发生PEP的38例患者为PEP组,同时选择同期行相同手术且手术成功、术后恢复良好的152例患者为对照组。回顾性分析两组患者的临床资料,记录并分析比较所有患者的年龄、孕次、体重指数(BMI)、停经时间、既往输卵管手术史、术后血清β-人绒毛膜促性腺激素(β-hCG)下降率、输卵管妊娠部位、异位妊娠病灶情况、术中盆腔粘连情况等。分析两组的临床基线资料,采用χ2检验进行输卵管妊娠术后PEP危险因素的单因素分析,采用Poisson回归进行多因素分析,筛选输卵管妊娠术后PEP的独立危险因素,并分析输卵管妊娠术后PEP的治疗方法等。结果 PEP组的年龄、孕次、BMI、停经时间等与对照组比较差异均无统计学意义(P>0.05)。单因素分析结果显示,输卵管妊娠手术后PEP的发生与急诊/择期手术、盆腔粘连、输卵管妊娠病灶破裂/流产有关,差异有统计学意义(P<0.05),而与手术方式、输卵管妊娠部位、输卵管妊娠病灶大小等无明显相关。Poisson回归分析结果显示,盆腔粘连、输卵管妊娠病灶破裂/流产是输卵管妊娠术后发生PEP的独立危险因素。输卵管妊娠患者手术后发生PEP的患者95%可经药物治疗成功。结论 盆腔粘连、输卵管妊娠病灶破裂/流产是输卵管妊娠术后发生PEP的独立危险因素。

输卵管妊娠术  /  持续性异位妊娠  /  危险因素

Objective To explore the risk factors of persistent ectopic pregnancy (PEP) in patients with fallopian tubal pregnancy after tubal pregnancy surgery. Methods A total of 38 patients, who underwent the tubal pregnancy surgery in International Peace Maternity and Child Health Hospital affiliated to Medical College of Shanghai Jiao Tong University from January 2000 to December 2020, were selected as the research subjects and included into PEP group; and another 152 patients undergone the same operation during the same period and recovered well were selected as control group. The clinical data of the two groups were analyzed retrospectively. The age, gravidity, body mass index (BMI), menopause duration, previous fallopian tube surgery history, postoperative serum β-human chorionic gonadotropin (β-HCG) decline rate, tubal pregnancy site, ectopic pregnancy focus, and intraoperative pelvic adhesion etc. of all patients were recorded and analyzed. The clinical baseline data of the two groups were analyzed. The chi square test was used to analyze the risk factors of PEP after tubal pregnancy surgery, and Poisson regression analysis was performed to do the multivariate analysis. The independent risk factors of PEP after tubal pregnancy surgery were screened, and then the treatment method of PEP after tubal pregnancy surgery was analyzed. Results There were no significant differences between PEP group and control group in terms of age, gravidity, BMI and menopause duration. Univariate analysis showed that the PEP after tubal pregnancy surgery was related to emergency/elective surgery, pelvic adhesion and the rupture of ectopic pregnancy lesions/abortion, and the difference was statistically significant (P<0.05), while no obvious relation to the operation method, the location of tubal pregnancy and the size of ectopic pregnancy focus. Poisson regression analysis showed that the pelvic adhesion and the rupture of ectopic pregnancy lesions/abortion were the independent risk factors of PEP. The cure rates with methotrexate (MTX) treatment was 95% for PEP patient after tubal pregnancy surgery. Conclusion The pelvic adhesion and the rupture of ectopic pregnancy lesions/abortion were the independent risk factors of PEP after the tubal pregnancy surgery.

operation of fallopian tubal pregnancy  /  persistent ectopic pregnancy  /  risk factor
于津, 杨思勤. 输卵管妊娠术后持续性异位妊娠的危险因素分析. 解放军医学杂志, 2022 , 47 (2) : 157 -161 . DOI: 10.11855/j.issn.0577-7402.2022.02.0157
Jin Yu, Si-Qin Yang. Risk factors of persistent ectopic pregnancy after tubal pregnancy surgery[J]. Medical Journal of Chinese People’s Liberation Army, 2022 , 47 (2) : 157 -161 . DOI: 10.11855/j.issn.0577-7402.2022.02.0157
异位妊娠是指受精卵在宫腔外着床,占所有妊娠的1.5%~2.0%[1],其中输卵管妊娠占异位妊娠的90%[2],其治疗方法包括期待治疗、药物治疗、保守性手术治疗及根治性手术治疗[3]。持续性异位妊娠(persistent ectopic pregnancy,PEP)是指初次治疗后,滋养细胞组织未被完全去除而继续生长,血清β-人绒毛膜促性腺激素(β-hCG)水平持续升高或不降低,伴或不伴临床症状[4]。有研究发现,保守性手术后PEP的发生率为5%~20%,而根治性手术后PPE的发生率<1%[5-7],故既往研究均集中在保守性手术后的PEP,但近年随着腹腔镜微创技术的开展,根治性手术后PEP的发生率有所升高[8]。本研究通过分析20年间上海交通大学医学院附属国际和平妇幼保健院输卵管妊娠术后发生PEP患者的一般临床资料,探讨了输卵管妊娠术后发生PEP的高危因素,以及输卵管妊娠术后PEP患者药物治疗的可能性,以期为此类患者的临床治疗提供参考.
回顾性分析2000年1月-2020年12月上海交通大学医学院附属国际和平妇幼保健院收治的接受输卵管妊娠手术[包括保守性手术(异位妊娠输卵管开窗术、异位妊娠输卵管挤压术、盆腔异位妊娠病灶清除术等)及根治性手术(异位妊娠输卵管切除术)]患者的临床资料。将术后发生PEP的38例患者作为PEP组(包括保守性手术23例,根治性手术15例)。采用1:4配比病例对照研究的方法,选取与PEP组年龄相差1岁,同时期入院并在本院接受相同手术治疗,且术后达到预期效果的152例输卵管妊娠患者作为对照组。本研究获上海交通大学医学院附属国际和平妇幼保健院伦理委员会审核批准(2019060),所有研究对象均签署知情同意书。
输卵管妊娠诊断标准:将术中输卵管或输卵管内清除的组织送病理学检查,可见绒毛组织者,则诊断为输卵管妊娠。PEP诊断标准:输卵管妊娠患者术后监测血清β-hCG水平出现升高或处于平台期者,诊断为PEP。输卵管妊娠术后第1天检测血清β-hCG水平,随后每周检测一次血清β-hCG水平。如怀疑PEP则根据需要缩短监测间隔时间。
纳入标准:(1)两组患者均接受了输卵管妊娠手术,术后病理均证实为输卵管妊娠;(2)临床资料完整。排除标准:(1)存在宫内外复合妊娠;(4)术中使用了氨甲蝶呤(MTX);(3)临床病例资料不完整。
采集两组患者的一般临床资料[年龄、孕次、体重指数(BMI)、停经时间、既往输卵管妊娠史,既往盆腔手术史等]、术前血清β-hCG水平及术中指标(手术方式、手术路径、急诊/择期手术、盆腔粘连、输卵管妊娠的部位、输卵管妊娠病灶破裂/流产、盆腹腔积血量等)。盆腔粘连是指盆腔内的脏器与周围组织的异常附着粘连,尤其是输卵管解剖结构发生改变,与盆侧壁、子宫、卵巢或肠管异常附着粘连;输卵管妊娠病灶破裂是指输卵管浆肌层破裂;输卵管妊娠流产是指输卵管浆肌层完整,妊娠物从输卵管伞端流产至盆腹腔。
分析两组患者的临床资料,筛选包括一般资料及术中情况等因素进行单因素分析,有统计学意义的因素再进行多因素分析,最终确定输卵管妊娠术后PEP的独立危险因素。同时分析输卵管妊娠术后PEP的治疗方法及并发症。
采用SPSS 22.0软件进行统计分析。患者的年龄、BMI等正态分布的计量资料以$\bar{x}±s$表示,两组间比较采用t检验,孕次等偏态分布资料以M(Q1Q3)表示,两组间比较采用Mann-Whitney U检验;计数资料以例(%)表示,危险因素的单因素分析比较采用χ2检验;多因素分析采用Poisson回归分析。P<0.05为差异有统计学意义。
两组患者的年龄、孕次、BMI、停经时间等一般临床资料比较差异均无统计学意义(P>0.05,表1)。
单因素分析显示,输卵管妊娠术后发生PEP与急诊/择期手术、盆腔粘连、异位妊娠病灶破裂/流产有关,差异有统计学意义(P<0.05);而与术前血清β-hCG水平、手术方式、输卵管妊娠部位、输卵管妊娠病灶大小等无关(P>0.05)(表2)。
将单因素分析有统计学意义的指标代入多因素泊松回归分析模型,结果显示盆腔粘连、输卵管妊娠病灶破裂/流产是输卵管妊娠术后发生PEP的独立危险因素(表3)。
PEP组38例患者于术后(13.9±2.0) d被诊断为PEP。其中37例采用氨甲蝶呤(MTX)注射治疗方案,仅1例再次手术治疗。37例MTX药物治疗均取得成功,其中30例采用单剂量治疗,5例采用二剂量治疗,2例采用多剂量治疗,治疗成功率97%。
PEP组38例术后均规范随访血清β-hCG,且未发生PEP的并发症。仅1例PEP患者在行MTX二剂量治疗时发生了轻微的化疗反应,出现了牙龈出血、白细胞降低,经过对症处理后好转。
既往研究报道,异位妊娠术后发生PEP的高危因素包括既往异位妊娠病史、盆腔粘连、早期妊娠、病灶包块小、术前血清β-hCG水平低等,这些因素均可使PEP的发生率增高[9-14]。本研究结果与既往文献报道略有不同。本研究发现,输卵管妊娠病灶破裂/流产及盆腔粘连是输卵管妊娠术后发生PEP的独立危险因素,而手术方式、急诊/择期手术、异位妊娠病症大小、术前β-hCG水平等均不是输卵管妊娠术后发生PEP的独立危险因素。这可能与近年临床医师对异位妊娠的诊治水平提高及腹腔镜手术技术的进步有关,尤其是对PEP认识的深入及警惕性的提高,使临床医师在手术时机的选择及术中病灶的处理中更加成熟、谨慎,避免了在异位妊娠诊断不明确时过早干预,从而使早期妊娠、异位妊娠病灶过小等不再是危险因素。
异位妊娠输卵管病灶不完整,发生破裂或流产时,均可使妊娠滋养细胞从输卵管中扩散至盆腔或腹腔,因而在术中可能无法完全清除有活性的滋养细胞,使盆腔或腹腔妊娠病灶残留,最终导致PEP的发生。盆腔粘连可使输卵管解剖结构发生改变,在术中游离输卵管时,由于输卵管充血水肿,异位妊娠病灶容易破裂,从而使妊娠的滋养细胞从输卵管扩散至盆腔,导致滋养细胞未被完全清除而引起PEP。此外,盆腔粘连可能由盆腔的慢性炎症所致,导致盆腔各个脏器的相互附着等,术中妊娠的绒毛容易残留在解剖结构发生改变的盆腔,从而导致输卵管妊娠术后PEP的发生。因此,术中应谨慎操作,洗净所有血块、破碎组织,包括尽可能扩大面积冲洗盆腹腔,尽可能减小头低脚高体位的角度,以避免滋养细胞残留于上腹腔,小心取出滋养细胞组织或输卵管,确保无滋养细胞组织残留;建议对所有的异位妊娠病灶,尤其是较大的病灶,均使用取物袋。
本研究还发现输卵管妊娠的手术方式并非PEP的独立危险因素。输卵管妊娠手术方式的选择往往建立在术中对病灶的范围、对侧输卵管、异位妊娠史及对未来生育能力要求评估的基础上。Mol等[15]的一项随机对照试验(RCT)评估了输卵管开窗术与输卵管切除术对生育前景的影响,结果发现,输卵管切除组术后36个月的自然受孕率与输卵管开窗组比较差异无统计学意义(56.2% vs. 60.7%);Fernandez等[16]的多中心RCT比较了根治性手术与保守性手术后2年患者受孕能力的差异,结果发现根治性手术组的受孕率与保守性手术组比较差异也无统计学意义(64% vs. 70%)。因此,如患者对侧输卵管正常,则病变侧输卵管开窗与输卵管切除对术后妊娠率无明显影响。本研究也发现,手术方式(保守性手术与根治性手术)不是输卵管妊娠术后发生PEP的危险因素(P>0.05),这可能与近年临床医师对PEP的深入了解,以及腹腔镜微创操作技术的提高有关。综上,输卵管妊娠手术方式不是术后发生PEP的独立危险因素,两种手术方式的术后受孕率也无明显差异。
对于输卵管妊娠术后患者,若预测提示PEP高风险,术后可早期行药物治疗。有研究对28例因异位妊娠接受保守手术治疗的患者进行回顾性分析发现,26例(92.8%)手术治疗成功后未发生PEP,而发生PEP的2例患者均接受MTX治疗,1例治疗成功,1例治疗失败行根治性手术后痊愈[17]。本研究38例PEP中,37例采用了药物治疗,仅1例行保守性手术的患者因肝功能指标轻微升高,无法采用药物治疗,故选择再次行根治性手术。37例PEP患者MTX药物治疗均取得了成功,其中30例采用了单剂量治疗,5例采用了二剂量治疗,2例采用多剂量治疗。本研究输卵管妊娠术后发生PEP行MTX治疗的成功率为97%,提示输卵管妊娠术后发生PEP及时行药物治疗的成功率较高。38例PEP患者术后均未发生并发症,仅1例PEP患者在行MTX二剂量治疗时发生了轻微的化疗反应,出现了牙龈出血、白细胞降低,经对症处理后好转。
综上所述,本研究结果显示,输卵管妊娠术后发生PEP的独立危险因素为输卵管妊娠病灶破裂/流产及盆腔粘连,两者均可能使术中无法完全清除妊娠滋养细胞,从而导致术后PEP的发生,故对于此类患者,术中应提高警惕、细致操作,避免残留滋养细胞。此外,本研究还发现,输卵管妊娠术后PEP早期药物治疗效果良好。但本研究尚存在一些局限,如纳入患者的样本量较少,以及未对输卵管妊娠术后血清β-hCG下降的趋势进行分析等。在今后的临床研究中,应进一步扩大样本量,并提高研究设计的科学性及完整性,以期为输卵管妊娠术后PEP的临床防治提供依据。
  • 上海交通大学医工交叉项目(YG2019QNA08)
参考文献 引证文献
排序方式:
[1]
Chong KY, Mak YK, Vollenhoven B, et al. An audit of management of ectopic pregnancy in a major tertiary healthcare service[J]. Fertil Reprod, 2021, 3(1): 14-18.
[2]
Webster K, Eadon H, Fishburn S, et al. Ectopic pregnancy and miscarriage: diagnosis and initial management: summary of updated NICE guidance[J]. BMJ, 2019, 367: l6283.
[3]
Fan SD, Huang XD, Xiao C, et al. Salpingotomy versus salpingectomy for the treatment of tubal ectopic pregnancy: a meta-analysis[J]. Pract J Clin Med, 2018, 15(6): 194-197.
[范蜀东, 黄学丹, 肖超. 输卵管切除与输卵管开窗取胚术输卵管妊娠的Meta分析[J]. 实用医院临床杂志, 2018, 15(6): 194-197.]
[4]
Graczykowski JW, Seifer DB. Diagnosis of acute and persistent ectopic pregnancy[J]. Clin Obstet Gynecol, 1999, 42(1): 9-22.
[5]
Ting WH, Lin HH, Hsiao SM. Factors predicting persistent ectopic pregnancy after laparoscopic salpingostomy or salpingotomy for tubal pregnancy: a retrospective cohort study[J]. J Minim Invasive Gynecol, 2019, 26(6): 1036-1043.
[6]
Jin QY, Jin XY, Zhang SY. The clinical efficacy of laparoscopic cornuotomy on interstitial tubal pregnancy which diameter was shorter than 3 cm[J]. Natl Med J China, 2020, 100(14): 1077-1080.
[金倩燕, 金小英, 张松英. 腹腔镜下切开取胚术治疗直径小于3 cm输卵管间质部妊娠的效果分析[J]. 中华医学杂志, 2020, 100(14): 1077-1080.]
[7]
Lund CO, Nilas L, Bangsgaard N, et al. Persistent ectopic pregnancy after linear salpingotomy: a non-predictable complication to conservative surgery for tubal gestation[J]. Acta Obstet Gynecol Scand, 2015, 81(11): 1053-1059.
[8]
Zhang Y, Chen J, Lu W, et al. Clinical characteristics of persistent ectopic pregnancy after salpingostomy and influence on ongoing pregnancy[J]. J Obstet Gynaecol Res, 2017, 43(3): 564-570.
[9]
Song JH, Wang KF, Zhang J, et al. Multivariate analysis on persistent ectopic pregnancy after laparoscopic conservative surgery for tubal pregnancy[J]. Chin J Minim Inva Surg, 2016, 16(8): 677-680.
[宋菁华, 王克芳, 张军, 等. 腹腔镜输卵管妊娠保守性手术后发生持续性异位妊娠的多因素分析[J]. 中国微创外科杂志, 2016, 16(8): 677-680.]
[10]
Kayatas S, Demirci O, Kumru P, et al. Predictive factors for failure of salpingostomy in ectopic pregnancy[J]. J Obstet Gynaecol Res, 2014, 40(2): 453-458.
[11]
Li X, Zhang C, Li Y, et al. Predictive values of the ratio of beta-human chorionic gonadotropin for failure of salpingostomy in ectopic pregnancy[J]. Int J Clin Exp Pathol, 2019, 12(3): 901-908.
[12]
Rouse CE, Eckert LO, Babarinsa I, et al. Spontaneous abortion and ectopic pregnancy: case definition & guidelines for data collection, analysis, and presentation of maternal immunization safety data[J]. Vaccine, 2017, 35(48 Pt A): 6563-6574.
[13]
LeMaistre A, Bracey A, Katz A, et al. Role of qualitative choriogonadotropin assays in diagnosis of ectopic pregnancy[J]. Clin Chem, 2020, 33(10): 1908-1910.
[14]
Lin S, Yang R, Chi H, et al. Increased incidence of ectopic pregnancy after in vitro fertilization in women with decreased ovarian reserve[J]. Oncotarget, 2017, 8(9): 14570-14575.
[15]
Mol F, van Mello NM, Strandell A, et al. Salpingotomy versus salpingectomy in women with tubal pregnancy (ESEP study): an open-label, multicentre, randomised controlled trial[J]. Lancet, 2014, 383(9927): 1483-1489.
[16]
Fernandez H, Capmas P, Lucot JP, et al. Fertility after ectopic pregnancy: the DEMETER randomized trial[J]. Hum Reprod, 2013, 28(5): 1247-1253.
[17]
Sowter MC, Farquhar CM, Petrie KJ, et al. A randomised trial comparing single dose systemic methotrexate and laparoscopic surgery for the treatment of unruptured tubal pregnancy[J]. BJOG, 2001, 108(2): 192-203.
2022年第47卷第2期
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doi: 10.11855/j.issn.0577-7402.2022.02.0157
  • 接收时间:2021-08-26
  • 首发时间:2025-12-17
  • 出版时间:2022-02-28
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  • 收稿日期:2021-08-26
  • 录用日期:2021-12-30
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Medical Engineering Cross Project of Shanghai Jiao Tong University(YG2019QNA08)
上海交通大学医工交叉项目(YG2019QNA08)
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    上海交通大学医学院附属国际和平妇幼保健院妇产科/上海市胚胎源性疾病重点实验室/上海市临床重点专科建设—“强主体”妇产科,上海 200030

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2种不同金属材料的力学参数

Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)

Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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