人工流产术后恢复性生活时间与继发性不孕的相关性分析

Correlation between postoperative recovery time of sex life after abortion and secondary infertility

目的：研究人流术后恢复性生活时间与继发性不孕的相关性,以便指导临床患者。方法：回顾性分析2013年5月至2014年5月间入院诊治的600例人工流产术患者的临床资料,根据其术后恢复性生活时间将其分为三组,A组：〈2周组（91例）、B组：2-4周组（108例）及C组：〉4周组（401例）,统计三组患者术后1年内发生继发性不孕的发生率,比较三组患者的相关指标,分析人流术后恢复性生活时间与患者发生继发性不孕的相关性。结果：600例患者术后发生继发性不孕为60例,其中A组患者不孕22例（24.18%）,B组患者发生不孕12例（11.11%）,C组患者发生不孕26例（6.48%）,三组患者发生术后不孕率比较,差异有统计学意义（P〈0.05）。人流术后发生继发性不孕的原因主要是输卵管阻塞（46.67%）,其次是子宫内膜异位症（26.67%）,再次是盆腔粘连（21.66%）。人流术后继发性不孕患者性传播微生物中HPV约为51.67%,HSV-2约为43.33%,Ct则为31.67%,Uu则为36.67%、NG则为23.33%。对各变量行Pearson相关性分析,继发性不孕与人流术后恢复性生活时间呈负相关（r=-0.622,P〈0.01）。继发性不孕与性传播微生物呈现正相关（r=0.531,P〈0.01）。人流术后恢复性生活事件与性传播微生物呈负相关（r=-0.576,P〈0.01）。结论：人流术后过早恢复性生活可能会增加性传播微生物的滋生,进而引发输卵管阻塞,导致继发性不孕。建议人流术后至少4周后恢复性生活。

Objectives： To study the correlation between postoperative recovery time of sex life after abortion and secondary infertility,in order to guide patients in clinical. Methods： A retrospective analysis was conducted on the clinical data of 600 hospitalized patients underwent abortion from May 2013 to May 2014,who according to their postoperative recovery time of sex life were divided into three groups,Group A（ ≤2 week group,91 cases）,group B（ 2 - 4 weeks group,108 cases） and Group C（ ≥4 weeks group,401 cases）. The incidence of secondary infertility in the three groups a year postoperatively was surveyed,and related indicators of the three groups were compared,to analyze the correlation between postoperative recovery time of sex life after abortion and secondary infertility. Results： There were 60 cases of secondary infertility in the 600 subjects,including 22 cases in group A（ 24. 18%）,12 cases in group B（ 11. 11%）,and 26 cases in group C（ 6. 48%）,with statistically significant difference between groups（ P〈0. 05）. The main causes for secondary infertility after abortion included tubal occlusion（ 46. 67%）,followed by endometriosis（ 26. 67%） and pelvic adhesions（ 21. 66%）. In patients with secondary infertility after abortion,the sexually transmitted were mainly HPV（ 51. 67%）,HSV- 2（ 43. 33%）,CT（ 31. 67%）,UU（ 36. 67%） and NC（ 23. 33%）. According to Pearson correlation analysis,secondary infertility was negatively correlated with the postoperative recovery time of sex life after abortion（ r =- 0. 622,P〈0. 01）.Secondary infertility was positively correlated with sexually transmitted microbes（ r = 0. 531,P〈0. 01）. Postoperative recovery time of sex life after abortion and sexually transmitted microbes was negatively correlated（ r =- 0. 576,P〈0. 01）. Conclusion： The early recovery of sexual activity after abortion may increase the spread of microbes,leading to fallopian tube obstruction and secondary infertility. It is recommended that sex life not be restored for at least four weeks after abortion.