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目的:对376例异位妊娠患者进行临床分析,了解人工流产次数及输卵管粘连程度与异位妊娠发生的相关性。方法:选择2007年～2011年经过手术治疗(包括开腹手术和腹腔镜手术)的异位妊娠患者作为研究对象,将研究对象分为以下几种情况进行对比:①有人工流产史及无人工流产史两组,比较异位妊娠率;人工流产次数≥3次及<3次的两组,比较异位妊娠比率。②术中运用1985年美国生育协会修订的r-AFS分期系统对输卵管粘连进行评分,将研究对象分为以下3组:<5分,5～20分,>20分,比较异位妊娠率。结果:376例异位妊娠患者,有流产史237例,占63.03%,其中流产<3次189例,占50.26%,流产≥3次48例,占12.77%。既往盆腔炎史150例,占39.89%;术中发现输卵管粘连122例,占32.45%;评分<5分75例,占19.95%;评分5～20分47例,占7.18%。结论:异位妊娠发生相关因素较多,人工流产、输卵管粘连程度与异位妊娠的发生有密切的相关性。做好避孕宣教、避免非意愿性妊娠、降低人工流产率、积极预防生殖系统感染,是降低异位妊娠发生率的重要措施。
Objective: To analyze the clinical data of 376 patients with ectopic pregnancy and find out the correlation between the number of induced abortion and the degree of tubal adhesions and ectopic pregnancy. Methods: Patients with ectopic pregnancy who underwent surgical treatment (including laparotomy and laparoscopic surgery) from 2007 to 2011 were selected as the research objects. The subjects were divided into the following categories for comparison: ① There was a history of artificial abortion and no artificial Abortion history of two groups, compare the rate of ectopic pregnancy; the number of induced abortion ≥ 3 times and <3 times the two groups, compare ectopic pregnancy rate. ② During operation, the tubal adhesions were scored by r-AFS staging system revised by American Fertility Association in 1985, and the subjects were divided into the following three groups: <5, 5-20,> 20, comparing ectopic pregnancy rate. Results: Of the 376 ectopic pregnancy patients, 237 cases were abortion history, accounting for 63.03%. Among them, 189 cases were miscarried <3 times, accounting for 50.26%, miscarriage ≥ 3 times 48 cases, accounting for 12.77%. Previous pelvic inflammatory disease history of 150 cases, accounting for 39.89%; 122 cases found tubal adhesions, accounting for 32.45%; score <5 points in 75 cases, 19.95%; score 5 to 20 points in 47 cases, accounting for 7.18%. Conclusion: There are many related factors of ectopic pregnancy, and the degree of induced abortion and tubal adhesions is closely related to the occurrence of ectopic pregnancy. Good contraceptive education, to avoid unwanted pregnancies, reduce the rate of abortion, and actively prevent the reproductive system infection, is an important measure to reduce the incidence of ectopic pregnancy.