输卵管妊娠病因分析368例

目的探讨输卵管妊娠的发病原因,以便减少输卵管妊娠的发生。方法对近6年的368例输卵管妊娠进行回顾性分析,从慢性盆腔炎、剖宫产、盆腔肿瘤、妊娠次数与计划生育措施行等因素分两个时间段对比分析,确定主要发病因素。结果慢性盆腔炎(慢性输卵管炎)、剖宫产、人工流产引起输卵管妊娠发病率明显增高(P<0.05)。初次妊娠为输卵管妊娠的发病率明显低于2次以上妊娠(P<0.05),而盆腔肿瘤、宫内节育器、避孕药、输卵管结扎术致输卵管妊娠发病比率无明显差异(P>0.05)。结论慢性盆腔炎(慢性输卵管炎)、多胎次妊娠、反复人工流产、剖宫产是导致输卵管妊娠的四大主要病因。采取避孕措施,减少多胎次妊娠,减少流产术,降低剖宫产率,加强输卵管疾病及盆腔炎的防治,以预防输卵管妊娠的发生。

Analysis of Causes for 368 Tubal Pregnancy Cases

Objective To explore the reasons for the incidence of tubal pregnancy, so as to reduce its incidence. Methods A retrospective analysis of 368 tubal pregnancy cases in the past 6 years （2003 -2008） was conducted, potential associated factors such as chronic pelvic inflammation, csections, pelvic tumors, times of pregnancy and birth control measures were investigated and compared in two 3-year-period, the main causes were determined. Results It was indicated by our data that chronic pelvic inflammation/chronic salpingitis, c-sections and induced abortions could significantly increase incidence rates of tubal pregnancy （P〈0.05）, significantly lower incidence was observed in first pregnancy cases than that from cases of more than 2 pregnancy （P〈0.05）, however, no significant difference was identified for the association of tubal pregnancy incidence with pelvic tumors, intro uterine devices, birth control pills or tubal ligation （P〉0.05）. Conclusion It revealed that mainly four factors including chronic pelvic inflammation/chronic salpingitis, multiple pregnancy, frequently induced abortions and c-sections caused tubal pregnancy, our observation suggested that tubal pregnancy could be prevented by taking birth-control measures, which result less multiple pregnancy, less abortion and remarkably reduced c-section rates; and that enhanced prevention and treatment of oviductual diseases and pelvic inflamrhation also reduced the incidence of tubal pregnancy.