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台湾一家机构 21 年的卵巢异位妊娠经验。

Twenty-one years of experience with ovarian ectopic pregnancy at one institution in Taiwan.

机构信息

Department of Obstetrics and Gynecology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.

出版信息

Int J Gynaecol Obstet. 2012 Nov;119(2):154-8. doi: 10.1016/j.ijgo.2012.06.008. Epub 2012 Aug 24.

Abstract

OBJECTIVE

To review the experience with patients with ovarian ectopic pregnancy (OEP) at Chang Gung Memorial Hospital, Lin-Kou Medical Center, Tao-Yuan, Taiwan, between 1989 and 2009.

METHODS

A retrospective review of the presentation, prevalence, diagnosis, and trends in treatment of patients with OEP, and the use of assisted reproductive technology (ART) procedures and intrauterine devices (IUD). The incidence rate ratios (IRR) of ectopic pregnancies (EPs) per live births, OEPs per EPs, and OEPs per live births were analyzed.

RESULTS

The 110 OEPs diagnosed comprised 2.0% of all EPs (n=5408) and 1:1543 of all live births, leading to a mean OEP per year of 5.24. Seventy-eight patients were managed with laparoscopy and 32 underwent laparotomy. Twenty-six (23.6%) patients used an IUD and 12 (10.9%) had undergone ART. OEP associated with ART increased in the last 10 years of the study period. The IRR of EPs per live births, OEPs per EPs, and OEPs per live births all increased between 1989 and 2009. Management of OEP tended to favor laparoscopy in the later years.

CONCLUSION

There was a trend toward better management of OEP with laparoscopy. ART has become a risk factor for OEP. The IRR of EPs per live births, OEPs per EPs, and OEPs per live births all increased over the 21-year period.

摘要

目的

回顾台湾长庚纪念医院林口医学中心 1989 年至 2009 年期间卵巢异位妊娠(OEP)患者的诊治经验。

方法

回顾性分析 OEP 患者的临床表现、发生率、诊断方法及治疗趋势,以及辅助生殖技术(ART)和宫内节育器(IUD)的应用。分析异位妊娠(EP)活产比、OEP/EP 比和 OEP/活产比的发生率比值比(IRR)。

结果

共诊断出 110 例 OEP,占所有 EP(n=5408)的 2.0%和所有活产儿的 1:1543,导致每年 OEP 的平均发生率为 5.24。78 例患者采用腹腔镜治疗,32 例行剖腹手术。26 例(23.6%)患者使用了 IUD,12 例(10.9%)接受了 ART。ART 相关 OEP 在研究期间的最后 10 年呈上升趋势。1989 年至 2009 年,EP 活产比、OEP/EP 比和 OEP/活产比的 IRR 均呈上升趋势。OEP 的治疗方法在后期更倾向于腹腔镜。

结论

腹腔镜治疗 OEP 的趋势有所改善。ART 已成为 OEP 的一个危险因素。在 21 年期间,EP 活产比、OEP/EP 比和 OEP/活产比的 IRR 均呈上升趋势。

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