异位妊娠与避孕方法使用的相关性分析

Correlation analysis between ectopic pregnancy and contraceptive methods

目的调查近10年来上海市异位妊娠发病率变化情况,并对异位妊娠与避孕方法使用的相关性进行分析。方法收集上海交通大学医学院附属国际和平妇幼保健院2002年、2007年及2012年住院异位妊娠数、妊娠总数及妇科住院总例数,了解异位妊娠发病率变化情况。将2010年6月至2011年12月在上海交通大学医学院附属国际和平妇幼保健院、上海交通大学医学院附属第六人民医院和上海市第八人民医院收治的800例异位妊娠患者作为观察组,同期700例宫内早期妊娠的妇女作为对照组,调查妊娠前使用的避孕方法,分析异位妊娠与避孕方法使用的相关性。结果 2002、2007、2012年异位妊娠发病率分别为2.4%、3.5%、4.4%,呈升高趋势(P<0.05)。观察组有47.2%(255/540)的患者避孕失败,低于对照组的90.3%(380/421)(P<0.05)。避孕失败的患者中,观察组带器妊娠占18.8%(48/255),服用紧急避孕药占37.6%(96/255),高于对照组[分别为5.8%(22/380)、32.4%(123/380)](P<0.05)。结论异位妊娠发病率逐年增加。对生育期女性加强避孕宣教,掌握正确的避孕方法,将减少异位妊娠的发生,保护生育期妇女的生殖健康。

Objective To investigate the change of occurrence of ectopic pregnancy during the last 10 years in Shanghai. To analyze the correlation between the ectopic pregnancy and contraceptive methods. Methods The total number of ectopic pregnancy,pregnancy and cases in department of gynecology of lnternational Peace Materity ＆ Child Health Hospital Affiliated to Shanghai Jiaotong University in 2002, 2007, 2012 were collected, the change of occurrence of ectopic pregnancy was analyzed. 800 cases of ectopic pregnancy in International Peace Materity ＆ Child Health Hospital Affiliated to Shanghai Jiaotong University, Shanghai Sixth People＇s Hospital Affiliated to Shanghai Jiaotong University Medical College and Shanghai Eighth People＇ s Hospital during Jun 2010 to Dec 2011 were selected into observation group, 700 cases of intrauterine pregnancy during the same period were selected into control group. The contraceptive methods of two groups were investigated, the relationship between ectopic pregnancy and contraceptive methods were analyzed. Results The ectopic pregnancy rate were 2.4 %, 3.5 % , 4.4 % in 2002, 2007, 2012 respectively, showing a trend of increase （P 〈 0. 05）. 47.2% （255/540） cases failed in contraception in observation group, which was less than the control group [ 90. 3 % （380/421）] （P 〈 0.05）. Among the cases failed in contraception, 18. 8 % （48/255） cases were with IUD and 37.6 % （96/255） cases were with emergency contraception, which were higher than the control group [ 5.8 % （22/380） ,32. 4 % （123/380） respectively] （P 〈 0. 05） . Conclusion The occurrence of ectopic pregnancy has increased by years. To strengthen propaganda and education of contraception for growth period women can reduce the incidence of ectopic pregnancy.