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目的:分析和探讨不同时期异位妊娠发病因素变迁以及当下两类特殊异位妊娠诊疗方法。方法:选取2006年10月~2007年9月的186例异位妊娠患者和2011年10月~2012年9月的382例异位妊娠患者为研究对象,前者为I组,后者为Ⅱ组,通过对患者相关发病因素(年龄、职业、孕产史、既往病史等)进行分析和比较,总结不同时期的异位妊娠发病因素变化。另外,阐述当下两类特殊异位妊娠诊疗方法。结果:两个组别患者在平均年龄的对比上,没有显著性差异(P>0.05)。Ⅱ组患者中,年龄在≤20岁、21~25岁以及26~30岁的患者构成比例有所增加,未育女性的比例也比10年前增加。职业分布中,工人、农民的占有比例有所下降,学生、职员、个体以及无业人员和干部的占有比例则逐年增加。在既往病史中,Ⅰ组的主要病史为放环,Ⅱ组中宫腔操作史、异位妊娠史、生殖道感染史以及相关腹部手术史有所上升。Ⅱ组的阴道灌洗史、人工助孕史、吸烟史、口服紧急避孕药史与Ⅰ组对比明显增高。宫角妊娠以及宫颈妊娠史两种异位妊娠,在诊疗方法上需要进行早期诊断,采取有效的治疗方法。结论:在10年过程中,异位妊娠发病因素发生了变化,治疗上也需要采取有效措施,减少异位妊娠的发生。
Objective: To analyze and discuss the changes of pathogenesis of ectopic pregnancy in different periods and the current two methods of diagnosis and treatment of ectopic pregnancy. Methods: A total of 186 ectopic pregnancy patients from October 2006 to September 2007 and 382 ectopic pregnancy patients from October 2011 to September 2012 were selected as study subjects, the former being Group I and the latter being Group II , Through the analysis and comparison of the patient-related risk factors (age, occupation, pregnancy history, past medical history, etc.), summarizes the changes of etiological factors in different stages of ectopic pregnancy. In addition, the current two types of ectopic pregnancy diagnosis and treatment methods. Results: There was no significant difference between the two groups in the mean age (P> 0.05). In group Ⅱ, the proportion of patients aged ≤20 years, 21 to 25 years and 26 to 30 years increased, while that of non-pregnant women increased more than 10 years ago. Occupation distribution, workers and peasants decreased the proportion of occupiers, students, staff, individuals and unemployed and cadres, the proportion of the population increased year by year. In the past medical history, the main medical history of group Ⅰ was releasing ring. The history of uterine cavity operation, ectopic pregnancy, genital tract infection and related abdominal surgery in group Ⅱ increased. Group Ⅱ vaginal lavage history, artificial pregnancy history, smoking history, history of oral contraceptives significantly increased compared with the group Ⅰ. Palace of pregnancy and cervical pregnancy history of two ectopic pregnancy, diagnosis and treatment needs in the early diagnosis, to take effective treatment. Conclusion: In 10 years, the etiological factors of ectopic pregnancy have changed, and the treatment also need to take effective measures to reduce the incidence of ectopic pregnancy.