2003年和2013年人工流产患者高危因素的变化及分析

Changes in the High-risk Factors of Induced Abortion in 2003 and 2013

目的通过分析我院10年间人工流产患者高危因素的变化,为降低高危人工流产数量、预防手术并发症及提高人工流产后服务质量提供理论依据。方法回顾性分析2003年和2013年盛京医院人工流产患者的一般情况及高危因素,比较高危因素数量及构成比的变化。结果与2003年相比,我院2013年人工流产患者非本地户籍及农村户籍者所占比例均明显增加(P<0.05),尤其是非本地户籍的患者所占比例由2003年的21.5%上升至2013年的44.9%。学历背景中大专及以上学历者所占比例明显增加(P<0.05),由2003年的23.4%上升至2013年的35.1%。2003年年龄≤20岁的患者仅占人工流产患者总数的1.5%,而2013年上升至4.5%。2003年我院计划生育门诊高危人工流产率为38.9%(1 380/3 544),前5位高危因素分别是半年内有终止妊娠或1年内有2次以上人工流产史或总计3次以上人工流产史、生殖系统肿物、剖宫产术后、稽留流产和带器妊娠。2013年高危人工流产率为66.5%(3 059/4 597),前5位高危因素变为剖宫产术后、稽留流产、生殖系统肿物、半年内有终止妊娠或1年内有2次以上人工流产史或总计3次以上人工流产史和年龄≤20岁。结论 10年间高危人工流产数量明显增加,高危因素构成发生明显变化,剖宫产术后、稽留流产及年龄≤20岁实施人工流产者明显增加是高危人工流产率增加的主要原因。

Objective To analyze the high-risk factors of induced abortion patients admitted in Shengjing Hospital during the last decade, so as to provide a theory basis for reducing the number of high-risk abortion, preventing surgical complications and improving the service quality of post-abor- tion care. Methods The general situation and high-risk factors of induced abortion patients in 2003 and 2013 in Shengjing Hospital were retrospec- tively analyzed, and the incidence rate of high-risk factors and the composition changes were compared. Results The population from other cities and from the countryside that required induced abortion in 2013 was significantly increased than that in 2003 （P 〈 0.05 ）, especially the proportion of patients from other cities rose from 21.5% in 2003 to 44.9% in 2013. The proportion of patients with high educational background （ junior college or above degrees ） was increased significantly during the decades, rose from 23.4% in 2003 to 35.1% in 20 13 （ P 〈 0.05 ）. In 2003, the percentage of the patient whose age was 20 years old or less was only 1.5%, and that figttre rose to 4.5% in 2013. In 2003, the high-risk abortion rate in Shengjing Hospital was 38.9% （ 1 380/3 544）. The top five factors were termination of gestation within half a year or more than 2 times within 1 year or a total of 3 or more times, the reproductive tract neoplasm, cesarean section, missed abortion, and a pregnancy complicated with intrauterine device in the uterus. In 2013, high-risk abortion rate was 66.5% （ 3 059/4 597 ）, the top five factors were cesarean section, missed abortion, the reproductive tract neoplasm, termination of gestation within half a year or more than 2 times within 1 year or a total of 3 or more times, and the age of 20 years old or less. Conclusion The number of high-risk abortion in the past decade is obviously increased, and the constitution of high-risk factors is changed. Cesarean section, missed abortion and perfomaing induced abortion in age 20 years old or less are the main reasons which significantly increased the high-risk abortion rate.