育龄期女性使用宫内节育器及避孕套后继发性不孕的危险因素研究  

Study on risk factors of secondary infertility in women of childbearing age after using intrauterine device(IUD)and condom

作　　者：杨冬[1] 王丽峰[1] 张颖 YANG Dong;WANG Lifeng;ZHANG Ying(Department of Gynecology,People’s Hospital of Lianjiang City,Lianjiang 524400,China)

机构地区：[1]廉江市人民医院,广东廉江524400

出　　处：《现代医院》2021年第7期1119-1121,1125,共4页Modern Hospitals

基　　金：广东省医学科研基金项目(20201270)。

摘　　要：目的研究育龄期女性使用宫内节育器(IUD)及避孕套后继发性不孕的危险因素。方法选择本院2016年3月—2020年3月本院收治的159例育龄期妇女作为研究对象。根据妇女妊娠情况将其分为继发性不孕组(35例)和再次妊娠组(124例)。收集两组临床资料,包括年龄、身体质量指数(BMI)、有无盆腔炎症、有无阴道炎、有无子宫内膜异位、有无子宫肌瘤、有无输卵管病变、避孕措施、IUD使用时间等。结果经单因素分析,与再次妊娠组相比,继发性不孕组子宫内膜异位、输卵管病变的妇女比例较高,且继发性不孕组妇女年龄较大、BMI较高,差异均有统计学意义(P<0.05);经ROC分析,BMI和年龄预测育龄期女性使用IUD及避孕套后继发性不孕的曲线下面积分别为0.807、0.826,均有P<0.05;经Logistic回归性分析证实BMI≥25.035 kg/m^(2)、年龄≥34.050岁、子宫内膜异位和输卵管病变是育龄期女性使用IUD及避孕套后继发性不孕的危险因素。结论影响育龄期女性使用宫内节育器及避孕套后继发性不孕的原因较为复杂,如BMI、年龄、子宫内膜异位、输卵管病变等都是其危险因素,其中BMI≥25.035 kg/m^(2)、年龄≥34.050岁是预测育龄期女性使用宫内节育器及避孕套后继发性不孕的最佳截断值,这对临床预测继发性不孕有一定参考价值。Objective To study the risk factors of secondary infertility in women of childbearing age after using intrauterine device(IUD)and condom.Methods 159 women of childbearing age in our hospital from March 2016 to March 2020 were selected as the research objects.They were divided into two groups:the secondary infertility group(35 cases)and the second pregnancy group(124 cases).Clinical data of the two groups were collected,including age,body mass index(BMI),pelvic inflammation,vaginitis,endometriosis,hysteromyoma,fallopian tube disease,contraceptive measures and IUD use time.Results By univariate analysis,compared with the second pregnancy group,the proportion of women with endometriosis and fallopian tube lesions in secondary infertility group was higher,and the age and BMI of women in secondary infertility group were older,and the differences were statistically significant(P<0.05);ROC analysis showed that the area under the curve of BMI and age predicting secondary infertility after IUD and condom use were 0.807 and 0.826 respectively,both P<0.05;Logistic regression analysis confirmed that BMI≥25.035 kg/m^(2),age≥34.050 years old,endometriosis and fallopian tube lesions were risk factors of secondary infertility after IUD and condom use.Conclusion The factors influencing the secondary infertility of women of childbearing age after using IUD and condom are complex,such as BMI,age,endometriosis and fallopian tube disease.Among them,BMI≥25.035 kg/m^(2) and age≥34.050 years are the best cut-off values for predicting the secondary infertility of women of childbearing age after using intrauterine device and condom,which is conducive to clinical prediction of secondary infertility Pregnancy.

关 键 词：宫内节育器 继发性不孕 危险因素 输卵管病变 子宫内膜异位 

分 类 号：R711.31[医药卫生—妇产科学]