未产妇药物流产术致继发性不孕153例临床分析

目的：探讨药物流产术后继发不孕的主要原因。方法：对药物流产术后继发不孕症153例病因统计，并和同期原发不孕症96例进行支原体（UU）、衣原体（CT）感染和输卵管梗阻情况对比。结果：①继发不孕组病因分类中前三位依次是输卵管梗阻、盆腔炎、排卵障碍性疾病；②药流术并发症中与输卵管梗阻关系最密切依次为感染流产、药流不全、流血时间过长；③输卵管梗阻的发生率随着药流次数的增加而增加；④继发不孕组有66例(43.14%)有不同程度输卵管梗阻，而同期原发不孕组21例(21.88%)，两组比较差异有统计学意义（P=0.001）；⑤继发不孕组UU 、CT感染率高于同期原发不孕组，差异有统计学意义（P＜0.001）。结论：输卵管梗阻是药流后继发性不孕的主要原因。未产妇药物流产存在一定的不安全性。

Analysis of Etiological Factor for 153 cases of Secondary Infertility after Drug Induced Abortion in Nulliparas

Objective:To explore the main causes of secondary infertility after drug induced abortion.Methods: To analyse the clinic data of 153 cases of patients suffered from female secondary infertility after drug induced abortion.At the same time,etiological survey of the 96 cases of primary infertility were did as the secondary infertility group by exminating for leucorrhea ureaplasma urealyticum(UU) and chlamydia trachomatis (CT),executing hysterosalpingography technique. Result: ①The main etiology in secondary infertility group was salpingemphraxis,pelvic infections and ovulation obstruction. ②Infectious abortion,uncomplete abortion and long term bleeding were closely related to fallopian tubal obstruction in the secondary infertility group after drug induced abortion. ③The incidence of salpingemphraxis increased as the drug induced abortion increasing. ④.66(43.14%) cases of deffrent degree of salpingemphraxis were found in the secondary infertility group,otherwise there were 21(21.88%) cases in the primary infertility group during the same period. The incidence of salpingemphraxis in the secondary infertility group was significantly higher than that in the primary infertility group（P=0.001) ⑤The infectious rate of UU and CT in the secondary infertility group was significantly higher than that in the primary infertility group（P＜0.001). Conclusion: Salpingemphraxis was the key sterile cause of the secondary infertility after drug induced abortion.Executing drug induced abortion to nulliparas had certain insecurity.