人工流产术后继发输卵管性不孕的相关因素分析

目的：探讨人工流产术后继发输卵管性不孕的可能因素。方法：选择2008年12月—2010年10月因输卵管性不孕于武警后勤学院附属医院妇产科行宫腹腔镜联合手术且有人工流产史的患者170例作为病例组，以原发性输卵管性不孕患者171例作为对照组。对2组进行访问性问卷调查，询问其一般情况、月经史、生育史等与不孕相关因素，所有信息录入ACCESS数据库，进行校对整理。结果：病例组初次性生活年龄＜21岁和性伴侣数≥2个的患者比例均高于对照组，差异有统计学意义（P＜0.05）；病例组盆腔炎的发生率显著高于对照组（χ2=5.62，P=0.02；OR=1.95，95%CI：1.12～3.40）；病例组有2次以上人工流产史的患者子宫内膜薄的发生率显著高于对照组（χ2=4.86，P=0.03；OR=2.37，95%CI：1.06～5.31）；病例组腔镜下输卵管阻塞、积水、扭曲、系膜囊肿和盆腔粘连的发生率与对照组相比差异无统计学意义（P＞0.05）。结论：未发现人工流产史与继发输卵管性不孕之间有直接联系，但人工流产与术后盆腔炎、子宫内膜薄等不孕因素有关，性生活史与人工流产的发生有直接关系。

Related Factors of Secondary Tubal Infertilities after Induced Abortion

Objective：To investigate the related factors of secondary tubal infertilities after induced abortion. Methods：The case group included 170 tubal infertility patients treated with induced abortions and hysteroscope combined with laparoscope operation from December 2008 to October 2010，and 171 primary infertility patients as control group. The investigators carried out questionnaire survey，including the general conditions，menstrual history，reproductive history，and so on. All the above data were inputted to Access System，proof reading and finished. Results：The proportion of primary sexual life younger than 21 years old and more than 2 sexual partners in the case group are higher than the control group（P＜0.05）；the pelvic inflammation incidence of the case group was more than the control group（χ2=5.62，P=0.02；OR=1.95，95%CI：1.12-3.40）； The patients treated with more than twice induced abortion had higher incidence of thinner endometrium than control group（χ2=4.86，P=0.03；OR=2.37，95%CI：1.06-5.31）. There was no significant difference between the tubal infertility treated with induced abortion and primary infertility at fallopian tube obstruction，hydrosalpinx，tubal infertilities，mesosalpinx cyst and pelvic adhesion by the laparoscope. Conclusions：There is no direct relation between induced abortion and tubal infertility，but induced abortion could cause pelvic inflammation and thinner endometrium，and the sexual history had close relation with induced abortion.