北京地区宫外孕与节育方法使用关系的流行病学调查  

An epidemiological study on the relationship of ectopic pregnancy and the use of contra-ceptives in Beijing.

作　　者：张倬敏 翁梨驹[2] 张芝燕 金绚绚 经小萍[2] 张立英 连石柱 崔颐冰 

机构地区：[1]国家计划生育委员会科学技术研究所,100081 [2]首都医学院附属朝阳医院 [3]北京市计划生育技术研究指导所

出　　处：《中国计划生育学杂志》1994年第1期38-43,61-62,共8页Chinese Journal of Family Planning

摘　　要：本研究对北京地区1990年间272余万育龄妇女(15～49岁)进行宫外孕发生率监测,共收集确诊宫外孕1420例。在育龄妇女总人群中宫外孕发生率为0.52/1000育龄妇女年。使用节育方法人群中宫外孕发生率为0.54/1000育龄妇女;已婚未使用节育方法人群则为1.80/1000育龄妇女,为使用节育方法者三倍。又应用相对优势比(RO_(MH))与归因危险度(AR)定量综合评价宫外孕与节育方法使用的关系,结果显示有效使用各种节育方法均不增加宫外孕发生危险。各种节育方法因其避孕效果及在人群中使用比例不同,其降低宫外孕发生的程度亦不同。TCu IUD有效使用,明显降低宫外孕发生危险。The incidence of ectopic pregnancy (EP)was studied during one year period of 1990 in Beijing area covering a total population of 2. 7 million women of reproductive age (15-49). One thousand four hundred and twenty cases with diagnosis of ectopic pregnancy confirmed by surgery and pathological findings or laparoscopy were recruited. The overall EP incidence was 0. 52/1000W (W = women of re-producive age). The incidence of EP was 0. 54/ 1000W in married women of current contraceptive user,while it was 1. 80/1000W in married women of non-user, which was 3 times higher. Relative odds and attributive risks of various methods were determined in order to evaluate the relationship between EP and contraceptive use quantitatively. The resuks showed that there was no increased risks of EP occurrence for all the contraceptive methods used as long as they were effective. Through calculation, each contraceptive method had individual effect on lowering the risk of EP occurrence according to their different efficacy and percentage of users. Stratification of the types of IUD revealed that Copper T IUD reduced the risk of EP most significantly when it was effective.Among the 1420 EP cases,the average age of cases was 31. 05,gravidity 2. 97 and parity 1. 03. 128 women were pritnigravida(9. 01%)and 241 nullipara (16. 97%). Nearly half of the EP cases had IUD in situ (708),and ovarian pregnancy was significantly higher in this group than that in the group without IUD (7. 49% versus 2. 81%). There was no death in this group. Comparative tubal pathological study was done in 285 cases with IUD-in-situ 150 cases and with-IUD 135 cases. Results showed that the detective rates of acute, subacute and chronic inflammatory changes of the oviducts were not different statistically. Stereomicroscopic study on the epithelium and villi of salpinx also showed no difference between the 2 groups. This further confirmed that IUD does not increase the risk of tubal damage.

关 键 词：异位妊娠 IUD 相对优势比 归因危险度 发生率 

分 类 号：R181.3[医药卫生—流行病学]