深圳市南山区异位妊娠发病现状的调查分析

Survey and Analysis on Incidence of Ectopic Pregnancy in Nan Shan District of Shenzhen

目的探讨异位妊娠发生相关现状及危险因素,为该病的防治策略提供依据。方法以2009年6月-2010年6月在南山医疗单位住院确诊的272例异位妊娠患者的临床病历资料及同期在三家医院门诊行流产的早孕妇女544例,按1∶2比例为研究对象。采用回顾性临床研究法对其年龄、孕次、子宫肌瘤史、避孕方式、盆腔手术史、异位妊娠史、慢性盆腔感染史等、采用多因素非条件Logistic回归分析,计数资料采用χ2检验,筛查异位妊娠发生的现状及相关危险因素。结果南山区异位妊娠发病率呈逐年升高趋势。采用多因素非条件Logistic回归法分析异位妊娠发生的相关危险因素分别为:慢性盆腔感染史(OR=2.589,P=0.012)、异位妊娠(OR=10.560,P=0.049)、放置IUD(OR=1.356,P=0.006)、盆腔手术史(OR=5.910,P=0.028)。χ2检验显示病例组感染情况明显高于对照组(P<0.05)。结论南山区异位妊娠发病率呈逐年升高趋势。其中慢性盆腔炎、放置IUD、口服紧急避孕药、盆腔手术史、异位妊娠史是异位妊娠发病的危险因素,其中生殖道感染为根本原因。

Objective To investigate the risk factors of ectopie pregnancy and current clinical management,and to provide a basis for the disease control strategies. Methods The clinical data of ectopie pregnancy （ ease group, n = 272） and early abortion women（ control group, n = 544 ） form June 2009 to June 2010 were analyzed retrospectively. The following factors were analyzed by retrospective clinical research method ： Age, gravidity, history of uterine fibroids, contraception, pelvic surgery, history of eetopic pregnancy, chronic pelvic infection history, etc. The multiple logistic regression analysis was used to estimate the association be- tween risk factors and occurrence of ectopic pregnancy. Chi-squared test was used for nominal（categorical） data. Results There was a tendency toward a increase of ectopic pregnancy in Nanshan District. The risk factors of ectopie pregnancy and its odds ratio （OR） form the muhvariate non-conditional Logistic regression analysis were as ibllows： chronic pelvic infection history（ OR = 2. 589, P = 0.012 ）, history of ectopic pregnancy （ OR = 10.560, P = 0. 049 ）, intrauterine device （ OR = 1. 356, P = 0.006 ）, lower abdominal surgery（ OR = 5. 910, P = 0. 028 ）. Chi-squared test showed that the infection was significantly higher in case group （ P 〈 0.05 ）. Conclusion Chronic pelvic inflammatory disease, placing IUD, oral emergency contraceptive, pelvic surgery, history of ectopic pregnancy is the risk factors for eetopie pregnancy ;in which the reproductive tract infections is the root cause.