宫内节育器合并异位妊娠的影响因素研究

Study on the influencing factors of intrauterine device combined with ectopic pregnancy

目的评价宫内节育器（IUD）合并异位妊娠的影响因素，促进育龄妇女安全避孕。方法采用病例对照研究方法，对57例确诊为带器异位妊娠病例，按照1：1比例匹配对照，使用统一的信息调查表，分析IUD合并异位妊娠发生风险的影响因素。结果单因素分析结果显示，妊娠组和对照组在孕次、盆腹腔手术史、置器后副反应的比较，差异有统计学意义（P〈0．05）。多因素Logistic回归分析结果显示，调整年龄、职业等因素，与孕次为1次者比较，孕次为2次、3次及以上的育龄妇女使用IUD合并异位妊娠的发生风险较高[OR=8．321（95％CI：2．395—28．910）和13．880（95％CI：3．700．52．073）]。结论使用不同类型的IUD不增加异位妊娠的发生风险，而妊娠次数多显著增加异位妊娠的发生风险。因此要做好避孕节育，避免意外怀孕，减少人工流产次数，有利于减少异位妊娠发生的风险。

Objective To evaluate the influencing factors of intrauterine device （IUD） combined with ectopic pregnancy, promote safe contraception of women of childbearing age. Methods A ease-control study was used in the study, 57 cases were diagnosed as IUD com- bined with ectopic pregnancy, then 1 ： l matched cases in control group were selected, a unified questionnaire was used in the study, the influencing factors of IUD combined with ectopic pregnancy were analyzed. Results Univariate analysis showed that there were statistically significant differences in gravidity, pelvic cavity surgery history, and adverse reactions between pregnancy group and control group （P〈 0. 05 ） . Multivariate logistic regression analysis showed that after adjusting age and occupation, compared with the cases with pregnancy history for one times, the risk of IUD combined with ectopic pregnancy among the women of childbearing age with pregnancy history for two times, three times or more than three times was higher （ OR= 8.3：21, 95% CI： 2. 395-28. 910; OR= 13. 880, 95% CI： 3. 700-52. 073） . Conclusion Using different types of IUD does not increase the risk of ectopic pregnancy, while more pregnancies significantly increase the risk of ectopic pregnancy. Therefore, it is beneficial to reduce the risk of ectopie pregnancy by using correct contraceptive methods, preventing unwilling pregnancy, and reducing the number of induced abortion.