剖宫产瘢痕部位妊娠的中文文献再分析

目的:了解中国剖宫产瘢痕部位妊娠(cesarean scar pregnancy,CSP)的文献现状。方法:万方数据中按检索词"瘢痕部位妊娠"或"瘢痕妊娠"或"切口妊娠"或"疤痕妊娠",选择"跨库检索"、"全部期刊",检索年限"1982—2015",检索关于CSP的所有中文文献。按"作者单位"所在省/直辖市、"发表时间"所在年度、"作者单位"所在医院的等级及相关合并症或并发症等进行统计分析。结果:①万方数据中关于CSP文献共4 281篇,共114 571例病例,"作者单位"涉及的省/直辖市/自治区共30个。"作者单位"前5位省份是广东、河南、浙江、江苏和湖北省,最后5位是新疆、海南、宁夏、甘肃和青海省。②万方数据中最早发表CSP文献时间是1999年,按"发表时间"所在年度分析,无论是文献数还是病例数,构成比均呈逐年增加趋势。③按"作者单位"所在医院的医院级别进行统计,三级医院、二级医院、一级医院、计划生育指导服务站等其他医疗单位、无法考查医院等级或未记录"作者单位"的文献数分别占59.87%、30.69%、2.50%、1.38%和5.56%,病例数分别占60.03%、30.93%、2.41%、1.20%和5.43%。④CSP处于早期妊娠、中期妊娠、晚期妊娠的病例数分别占98.70%、0.60%和0.70%;记录胎盘异常、异常妊娠及其他并发症分别占0.91%、0.04%和0.01%;记录体外受精-胚胎移植(IVFET)者13例(占0.01%)。结论:①中国CSP有地域性,其原因有待于研究。②CSP呈逐年增加趋势。③提高对CSP等剖宫产术后远期潜在严重并发症的认识,严格掌握剖宫产指征,控制剖宫产率,是防止或降低CSP的根本措施,可能也是未来减少医疗纠纷的关键。

Cesarean Scar Pregnancy:New Analysis on Chinese Literatures

Objective:To understand the present situation of cesarean scar pregnancy ( CSP ) in China . Methods:The WANFANG database was used to search all Chinese literatures on the CSP from 1982 to 2015 by the key words as "scar pregnancy", "pregnancy at the scar", "incision pregnancy" or all kinds of the Chinese expressions of "scar pregnancy", and by the search strategy as "cross-database search" and "all the journals". Statistical analysis was based on multiple parameters , including the province (or municipality), the year of publication, the rank of hospital, and the related complications. Results: ①There were a total of 4 281 articles on CSP and 114 571 cases. Thirty provinces (or municipalities) were involved, including the top 5 provinces of Guangdong, Henan, Zhejiang, Jiangsu and Hubei;and the last 5 provinces of Xinjiang, Hainan, Ningxia, Gansu and Qinghai. ② The article on CPS was firstly published in 1999. The number of literatures and the number of cases were increased year by year. ③The numbers of literatures were 59.87%, 30.69%, 2.50%, 1.38% and 5.56%; the numbers of cases 60.03%, 30.93%, 2.41%, 1.20% and 5.43%, in five ranks of hospitals: tertiary hospital, secondary hospital, primary hospital, other medical institution like the family planning guidance and service center, and other unasserted hospital. ④The numbers of cases of CSP at the early stage, the middle stage and the late stage of pregnancy were 98.70%, 0.60%and 0.70%, respectively. The incidences of abnormal placenta, abnormal pregnancy and other complications were 0 . 91%, 0 . 04% and 0 . 01%. Thirteen cases (0.01%) of IVF-ET were recorded. Conclusions:①There was a possible regional characteristic on the CSP in China. ②CSP showed a rapid increasing trend year by year. ③The fundamental measures to prevent or reduce CSP include preferably understanding the potential serious complications of CSP after cesarean section, strictly mastering the indication of cesarean section and controlling the rate of cesarean section.