节育术后继发性不孕症病因及相关危险因素研究

The Study of Causes and Relative Risk Factors in Patients with Secondary Sterility after Birth Control Operations.

目的:探讨各种节育术后继发性不孕症病因及相关危险因素,针对此病提出预防措施。方法:随机抽取316例节育术后继发性不孕症患者作为病例组,并按1:2匹配年龄、职业、居住地、婚姻状况基本相同的632名非不孕症妇女作为对照,进行病例一对照研究。患者平均年龄为29±5岁,健康对照组平均年龄为30±4岁。采取门诊询问、查阅病历、进行相关检查和人户调查相结合的方法,所获资料进行单因素和多因素条件Logistic回归分析。结果显示节育术后继发性不孕的直接病因为:输卵管阻塞(31.01％)、输卵管通而不畅(27.22％)、盆腔炎(11.71％)、子宫内膜炎(5.06％)、子宫肌炎(4.43％)、阴道炎(1.58％)、重度宫颈炎(2.53％)、子宫内膜发育不良(3.80％)、继发性闭经(4.11％)、宫腔粘连(2.53％)、宫颈管粘连(1.90％)、子宫内膜异位症(0.95％)、盆腔结核(1.27％)、子宫肌瘤(1.90％);相关危险因素为:既往妇科炎症史(OR=5.886)、人流次数≥2次(OR=2.135)、卫生习惯差(OR=4.28)、术后过早性生活(OR=2.357)、术后感染(OR=6.668)、术后阴道不规则出血(OR=1.936)、反复放置IUD史(OR=1.897)、施术单位(OR=1.236)。结论:探讨出节育术后继发性不孕症的病因及相关危险因素,从而有针对性地提出了防治措施。

Objective:To study the causes and relative risk factors in patients with secondary sterility after birth control operations, and bring forward prophylactico-therapeutic measuremonts. Methods : This study included 316 remale patients with secondary sterility after birth control operations and 632 health women. The patients' mean age is 29±5 years. The mean age of control group is 30±4 years. There are not difference between the two groups in ages professions, residence and marrage condition case-control study was used. All date of patients and control subjects were e-valuated with single factor and multiple factor Logistic regression analysis. Follow up patients in hospital or in patients home. Results: The causes of secondary sterility after birth control operation were oviduct obstruction (31. 01%), oviduct partial obstruction ( 27. 22%). Pelvic inflammatory disease (11. 71%) , endometritis (5.06%) , uterus myometritis(4. 43%) ,vaginitis(l. 58%), severe cervicitis(2. 53%) .hypogenesis of endometrium(3. 80%),secondary amenorrhea(4. 11%) .conglutination of intrauterine(2. 53%) .conglutination of cervix(1. 90%) .endomerriosis (0. 95%),pelvic tuberculosis (1. 27%),myoma of uterus (1. 90%). Relative risk factors are anamnesis of gynecological inflammation (OR = 5. 886),times of artificial abortion ≥2 (OR = 2. 135),bad sanitary habit(OR = 4. 28),early sexual life after operation(OR = 2. 357) postoperative infection (OR = 6. 668) .postoperative inegular vaginal bleeding(OR = 1. 936),history of implanting repeatedly IUD(OR = 1. 897), the units of operation(OR = 1. 236). Conclusion: We find more factors that can cause secondary sterility after birth control operations,so prophylactico therapeutie measure ments of secondary sterility must be braught forward.