我院近10年740例异位妊娠诊治变化

Change of Clinical Diagnosis and Treatment of Ectopic Pregnancy during 1997 to 2006

目的:分析我院近10年来异位妊娠发生率、发病年龄、诊断和治疗。方法:以5年为一个时间段回顾分析我院1997年1月至2006年12月异位妊娠发生率、发病年龄、诊断和治疗。结果:我院1997年1月至2006年12月共收治异位妊娠740例。异位妊娠数与同期宫内妊娠数之比,由1997年1月至2001年12月的1:23.99上升为2002年1月至2006年12月的1:11.60(P<0.01)。≤25岁异位妊娠的发病率由1997年至2001年的14.7%上升到2002年至2006年的28.9%,其中≤20岁妇女及合并不孕者有增多趋势。异位妊娠的早期诊断率增高,发生异位妊娠破裂者由1997年至2001年的120例(45.3%)下降至2002年至2006年的85例(17.9%)(P<0.01)。经腹行输卵管切除仍为主要治疗手段,但腹腔镜手术及保守性手术逐渐增多,非手术治疗明显增多。结论:异位妊娠发生率呈上升趋势,发病年龄年轻化,近年早期诊断率增高,减少误诊及异位妊娠破裂发生,经腹手术仍为主要治疗手段,但腹腔镜和保守治疗上升。

Objective：To investigate the incidence,age distribution,diagnosis and treatment of ectopic pregnancy during 1997 to 2006.Methods：Retrospectively analyze the incidence,age distribution,diagnosis and treatment of ectopic pregnancy during 1997 to 2006.Patients were divided into two groups according to observing time,1997-2001 group and 2002-2006 group.Results：During January 1997 to December 2006,740 cases of ectopic pregnancy were diagnosed and treated.①The ratio of number of ectopic pregnancy to simultaneous intrauterine pregnancy increased from 1：23.99 in 1997-2001 group to 1：11.60 in 2002-2006 group（P〈0.01）.②The constitution rate of ectopic pregnancy occurred in women aged 25 or less increased from 14.7% to 28.9%,especially in these women aged at 20 or less and accompanied with infertility.③The early diagnosis rate of ectopic pregnancy increased and the ratio of rupture in ectopic pregnancy decreased from 45.3%（120/265）to 17.9%（85/475）.④Abdominal salpingectomy remained as the main treatment,and the ratios of operative laparoscopy and conservative treatment increased slowly and non-surgical treatment increased predominantly.Conclusion：The incidence of ectopic pregnancy increased gradually and the trend of increased accurrence in young patients was observed.There was low misdiagnosis rate and rupture of ectopic pregnancy because of increased early diagnosis.Abdominal salpingectomy was the main treatment,and the rate of operative laparoscopy or conservative treatment increased gradually.