输卵管绝育手术并发症发生原因及影响因素的前瞻性研究  

Etiology and Risk Factors of Complications of Female Sterilization

作　　者：陆海音 陈云雁 张明秋 游顶云[3] 李江川 速存梅 宋向菁 白双勇 葛争鸣 王建兰 

机构地区：[1]云南省人口和计划生育科学技术研究所,云南省生育调节与少数民族优生研究重点实验室,昆明650021 [2]云南省人口和计划生育科学技术研究所 [3]哈尔滨医科大学卫生统计系

出　　处：《中国计划生育学杂志》2010年第1期10-13,共4页Chinese Journal of Family Planning

基　　金：科技部十一五国家科技支撑计划项目(项目编号2006BAI15B09)

摘　　要：目的:通过对输卵管绝育术前瞻性研究,分析绝育术并发症发生原因及影响因素,提出相关建议。方法:通过预防干预、诊断干预形成多环节的综合干预措施,分别观察干预组与对照组绝育手术并发症的发生率并分析原因。结果:干预组、对照组近期并发症发生率分别为0.88%、4.56%,两组差异有统计学意义(P(0.0001),远期并发症干预组、对照组分别为1.05%、0.46%。单因素分析结果显示:并发症发生的危险性与妇女年龄、痛经史、人流或流产/产后手术、既往患有妇科病史、输卵管取管指板法、输卵管折叠结扎切断法、术中提管困难等有关。多因素分析结果显示:对照组并发症的发病风险是干预组的7倍;采用输卵管折叠结扎切断法发生并发症的危险是输卵管抽芯近端包埋法的50倍;既往有妇科病史的妇女并发症发生率是正常妇女的4倍。结论:对于高风险人群(如年龄(35岁、既往有妇科病史等),应严格掌握适应证及禁忌证并谨慎手术。建议输卵管绝育取管采用吊钩法。输卵管绝育术术式采用并严格执行抽芯近端包埋法。Objective ： To explore the etiology and risk factors of complications of female sterilization and put forward some relevant suggestions. Methods： The comprehensive intervention including prevention and diagnosis was adopted. The incidence of complications of female sterilization was observed and the etiology analysis was conducted. Results： The incidence of the immediate complications in the intervention group and the control group were 0.88% and 4.56% respectively, showing significant differences between the two groups （ P 〈 0.001 ）. The incidence of the late complications in the intervention group and the control group were 1.05% and 0.46% , respectively. The single - factor analysis showed that risk for the occurrence of complications had relation to the age of women, history of dysmenorrbeal and gynaecological diseases, operation timing immediately after abortion or delivery, the methods of sterilization as well as operation with difficulty. The multivariate analysis showed that the mortality risk of the complications in the control group was 7 times of that of the intervention group. The incidence of the complications of operation with severing oviduct after folding and ligaturing was 50 times of that of modified Uchida operation. The incidence of the complications in women with history of gynaecologieal diseases was 4 times of that of the normal women. Conclusion： The indications and contraindications should be followed strictly for women over 35 years old as well as with history of gynaecological diseases. It is suggested that the hook should be used to raise the oviduct and the modified Uchida operation should be used in tubal sterilization.

关 键 词：输卵管绝育术 绝育术并发症 危险因素 

分 类 号：R713.5[医药卫生—妇产科学]