药物流产和手术流产与输卵管妊娠的相关性

目的调查药物流产和人工流产与输卵管妊娠的相关性,探讨两种终止早孕术式与输卵管妊娠发生的风险。方法对2003年1月~2006年12月在肇庆市端州区妇幼保健院接受手术治疗的194例输卵管妊娠病例,比对同期门诊药物流产1617例,人工流产12244例,根据以往孕产史及终止妊娠方式不同分为药流组,人流组和原发组,采用SPSS13.0软件,行多个样本比较的秩和检验和2检验。结果①药物流产后发生输卵管妊娠的风险为1/40,人工流产后发生输卵管妊娠的风险为1/130,差异非常显著(p<0.001)。②输卵管妊娠与分娩数之比为1/46,较[1]上海1995~1996年统计1/6.6低,较1993年北京报道1/90高。③不同组别输卵管妊娠发生部位均以壶腹部最高(占79.9%),盆腔粘连、婚姻状况各组间无统计学差异(p>0.05)。出血量以药流组最少,原发组最多(p=0.000);药流组与人流组比较,终止妊娠次数与输卵管妊娠发生有统计学意义,2=15.169,p=0.000,差异非常显著。结论药流后发生输卵管妊娠较人流后发生输卵管妊娠的风险高。

INVESTIGATION INTO THE CORRELATION BETWEEN MEDICINE ABORTION, SURGICAL ABORTION AND TUBAL PREGNANCY

Objective To investigate the correlation between medicine abortion, induced abortion and tubal pregnancy, and discuss the risk of terminate pregnancy and tubal pregnancy. Methods To compare 1617 cases of clinic medicine abortion of the corresponding period with 12244 cases of induced abortion against 194 cases of tubal pregnancy at Duanzhou Health - Care Hospital for Women and Children, Zhaoqing, during Jan. 2003 to Dec. 2006, and scores of samples of RSR and X2 tests by adapting the software SPSS13.0 based on the different groups of medicine abortion of previous pregnancy history and terminate pregnancy, induced abortion and primary group. Results ① The risk of tubal pregnancy is 1/40 after medicine abortion, 1/130 after induced abortion, and the difference is striking, p 〈0.001. ②The ratio of tubal pregnancy and delivery is 1/46, lower than the statistics 1/6.6 compared with Shanghai during 1995 - 1996 , higher than the reported statistics 1/90 of Beijing. ③The ampulla are the highest occurred sites among the groups of tubal pregnancy; producing no difference between each group of pelvic adhesions and marriage status, p 〉 0.05; with the least amount of bleeding in the groups of medicine abortion, the most in the primary ones, P = 0. 000; compared with the groups of medicine abortion and induced abortion, the occurrence of frequency of terminate and tubal pregnancy enjoys statistics significance, 2 = 15. 169 ,p = 0. 000, with striking difference. Conclusion There is a high - risk of the occurrence of tubal pregnancy after medicine abortion in comparison with the one after induced abortion.