影响异位妊娠发病的相关因素分析

Analysis of influence factors associated with ectopic pregnancy

目的异位妊娠是妇产科常见的急腹症之一,本研究的目的是分析异位妊娠发病的危险因素,为临床预防提高理论依据和指导。方法收集2009年1月—2011年12月收治于我院的160例异位妊娠患者和随机抽取的320例宫内妊娠患者的临床资料。采用单因素结合多因素非条件Logistic回归分析方法,探索异位妊娠发病的危险因素。所有统计资料用SPSS13.0统计分析系统进行分析。当P<0.05时差异有统计学意义。结果符合纳入标准的病例共480例,其中异位妊娠患者160例(33.3%),宫内妊娠320例(66.7%),患者平均年龄为(31.3±6.5)岁。单因素分析显示:盆腔炎史(P=0.010)、人工流产史(P=0.023)、药物流产史(P=0.024)、宫内节育器避孕(P=0.011)、盆腔手术史(P=0.016)与异位妊娠的发病显著相关;多因素Logistic回归分析显示:盆腔炎(OR,2.442;95%CI,1.210-4.930;P=0.013)、人工流产史(OR,2.094;95%CI,1.188-3.691;P=0.011)、药物流产史(OR,2.011;95%CI,1.055-3.835;P=0.034)、宫内节育器避孕(OR,3.140;95%CI,1.161-8.496;P=0.024)、盆腔手术史(OR,2.789;95%CI,1.167-6.666;P=0.021)是异位妊娠发病的独立危险因素。结论盆腔炎、人工流产、药物流产、宫内节育器避孕、盆腔手术是异位妊娠发病的独立危险因素,对于这些危险因素应给与积极的干预,降低异位妊娠的发病率。

Objective Ectopic pregnancy is one of acute abdominal diseases of gynaecology and obstetrics. The purpose of this research was to investigate risk factors associated with ectopic pregnancy, so as to provide theoretical evidence and guidance for clinical prevention. Methods A retrospective analysis was carried out in 160 patients with ectopic pregnancy from January 2009 to December 2011 in our hospital and 320 patients that were drew out randomly from patients with uterine pregnancy in the same period. The possible factors associated with ectopic pregnancy were investigated in univariate analysis and multivariate logistic regression model. Statistical analysis was performed with the SPSS statistical package （SPSS 13.0）. A value 〈0.05 was considered statistical significant. Results A total of 480 cases were included in this study. Of them, 160 （33.3%） presented with ectopic pregnancy and 320 （66.7%）presented with uterine pregnancy. The mean age of the patients was 31.3±6.5 years. Univariate analysis indicated that history of pelvic infection （P=0.010）, history of artificial abortion （P=0.023）, history of medical abortion （P=0.024）, contraception with intrauterine device （P=0.011）, history of pelvic operation （P=0.016）were significantly associated with ectopic pregnancy. Multivariate logistic regression analysis indicated that history of pelvic infection （OR, 2.442; 95%CI, 1.210-4.930; P=0.013）, history of artificial abortion（OR, 2.094; 95%CI, 1.188-3.691; P=0.011）, history of medical abortion （OR, 2.011; 95%CI, 1.055-3.835; P=0.034）, contraception with intrauterine device （OR, 3.140; 95%CI, 1.161- 8.496; P=0.024）, history of pelvic operation （OR, 2.789; 95%CI, 1.167-6.666; P=0.021） were independent risk factors of eetopic pregnancy. Conclusion History of pelvic infection, artificial abortion, medical abortion, contraception with intrauterine device, and history of pelvic operation were independent risk factors of ectopic pregnancy. Active intervention should be performed on these factors to reduce the rate of ectopic pregnancy.