1215例异位妊娠临床症状、治疗方法的现况调查

目的:了解深圳市异位妊娠的发生情况。方法:以2005年10月~2006年9月在深圳市22家医院确诊的宫外孕患者1215例为研究对象,对其生殖道感染史、人流史、避孕史、临床症状及治疗方法进行现况调查,同时对其中进行保守治疗的155例患者和238例早期终止妊娠者进行宫颈分泌物、沙眼衣原体、解脲支原体、人型支原体培养及淋球菌、加特纳杆菌培养检测比较。结果:异位妊娠与正常妊娠之比为1∶16,与人工流产之比为1∶31,总比为1∶47.8。82.38%的异位妊娠发生在20~35岁,且主要发生在流动人口、文化程度低和无正常职业、从事服务业的人群。病例组中曾患盆腔炎、输卵管炎者及宫颈微生物衣原体、解脲、人型支原体阳性率及淋球菌、加特纳菌感染率均高于对照组,经检验差异有统计学意义(P<0.05)。异位妊娠的临床症状以停经、腹痛、阴道出血为主,发生部位以输卵管(93.17%)为主,手术治疗占86.01%。结论:流动人口、文化程度低、无正常职业、从事服务业的人群及生殖道微生物感染为异位妊娠的高危因素。加强孕前检查、普及性卫生教育、积极防治生殖道感染将有利于降低异位妊娠的发生。

The research of symptom and clinical management of 1215 women with ectopic pregnancy in Shenzhen city

Objective:To investigate the symptom and current clinical management of ectopic pregnancy,and institute the control measures.Methods:Choose 1215 women with ectopic pregnancy as case group who were diagnosed by 22 hospitals in Shenzhen since October 2005 to September 2006.The groups were investigated with questionnaire about genital duct infection,abortions,procreation and so on.Compared 155 women who adopted the expectant treatment from case group with 238 normal pregnant women who ended their pregnancies in early time named control group by checking their secretion of cervix,chlamydia trachomatis(CT),ureaplasma urealyticum(UU),NG,mycoplasma hominis(MH),gardnrella vaginallis(GV).Results:The scale of ectopic pregnancy and normal pregnancy was 1∶16 in Shenzhen(1 215/19 764);and the scale of ectopic pregnancy and induced abortion was 1∶31(1 215/38 325).Total scale was 1∶47.8,higher than 1∶56～93 reported by domestic and oversea news.82.38% ectopic pregnancy presented to age 20～35,most of them were floating population,low education people and jobless people.In case group,their secretion of cervix,chlamydia trachomatis(CT),ureaplasma urealyticum(UU),NG,mycoplasma hominis(MH),gardnrella vaginallis(GV) all higher than control group(P<0.05).unemmenia,bellyache,vagina bleeding were the normally clinical symptom of ectopic pregnancy.93.17% of ectopic pregnancy appeared in fallopian tube.Operation was current clinical management,and it taken 86.01% from whole management method.Conclusion:Floating,low education,jobless population,and genital duct infection people are the high risk factors of ectopic pregnancy.Clinical management develops towards the nonoperatively,simply,efficiently way.Strengthen body check before pregnant,popularize the education of sex hygiene and prevent procreation system infection is useful for reduce the incidence of a disease of ectopic pregnancy.