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目的探讨不同时期异位妊娠发病因素的差异,以探索切实可行的干预措施。方法对首都医科大学附属北京妇产医院1997年10月～1998年9月期间(前期组)186例和2007年10月～2008年9月期间(后期组)382例异位妊娠患者发病的相关因素进行回顾性分析,包括年龄、婚姻状况、孕产史、职业分布、既往病史和治疗情况等。结果 2组患者平均年龄差异无统计学意义,后期组20岁以下构成比由10年前的1.1%上升至4.5%(P=0.006);未婚女性由1997年的21.5%上升至2007年的41.4%(P=0.000);未育女性由1997年的45.7%上升至2007年的66.8%(P=0.000);2组间孕、产次差异无统计学意义,但后期组流(引)产次数明显高于前期组(P=0.030);职业分布:工人、农民的构成比明显下降,干部、职员和学生、其他职业的构成比逐年上升(P=0.000);前期组患者宫内节育器病史明显多于后期组(P=0.000),而生殖道感染史和其他腹部手术史明显少于后期组(P=0.002,P=0.044)。后期组中阴道灌洗史、宫颈治疗史及吸烟史均较前期组明显增高(P=0.000,P=0.009,P=0.002)。结论 10年来异位妊娠发病相关因素发生了变化,应采取相应的措施,以降低异位妊娠的发生。
Objective To investigate the differences of etiological factors in ectopic pregnancy in different periods to explore practical interventions. Methods A total of 382 cases of ectopic pregnancy in Beijing Maternity Hospital Affiliated to Capital Medical University from October 1997 to September 1998 (the first group) and from October 2007 to September 2008 (the latter group) Retrospective analysis of factors, including age, marital status, maternal history, occupational distribution, previous medical history and treatment. Results There was no significant difference in mean age between the two groups. The proportion of the under-20s in the latter group increased from 1.1% 10 years ago to 4.5% (P = 0.006); the unmarried women increased from 21.5% in 1997 to 41.4 in 2007 % (P = 0.000). The number of non-fertile women increased from 45.7% in 1997 to 66.8% in 2007 (P = 0.000). There was no significant difference in pregnancy and parity among the two groups, (P = 0.030). The occupational distribution: the composition ratio of workers and peasants decreased significantly, and the proportions of cadres, staff and students and other occupations increased year by year (P = 0.000); the pre-treatment group’s IUD The history was significantly more than the late group (P = 0.000), while the history of genital tract infection and other abdominal surgery was significantly less than the late group (P = 0.002, P = 0.044). In the latter group, vaginal lavage history, history of cervical treatment and smoking history were significantly higher than those in the previous period (P = 0.000, P = 0.009, P = 0.002). Conclusion The related factors of ectopic pregnancy have changed during the past 10 years and corresponding measures should be taken to reduce the incidence of ectopic pregnancy.