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目的:探讨近30年异位妊娠发病率、发病类别,其中急症型异位妊娠发生例数、发病特点和发病部位的关系。方法:对1980～2009年收治的异位妊娠2 006例的资料进行回顾性分析。结果:①30年异位妊娠总数为2 006例,同期孕产妇76 105例,发生率为2.64%。发生率呈上升趋势:1980～1989年为0.31%(67/21 454),1990～1999年为1.31%(327/24899),2000～2009年为5.42%(1612/29 752),差异有统计学意义(P<0.01)。②2 006例异位妊娠中经手术和病检确诊的共1642例,占81.85%;药物和期待治疗364例,占18.15%。③手术所见(开腹和腹腔镜)类别:输卵管妊娠占97.32%(1 598/1 642),卵巢妊娠占1.04%(17/1 642),残角妊娠占0.61%(10/1 642),宫角妊娠占0.55%(9/1 642),腹腔妊娠占0.49%(8/1 642),输卵管妊娠最多,差异有统计学意义(P<0.01)。④急症型异位妊娠69例,发生率为4.20%(69/1 642);发生率和发病部位关系:腹腔妊娠为75.00%(6/8),残角妊娠40.00%(4/10),卵巢妊娠为35.29%(6/17),宫角妊娠为22.22%(2/9),输卵管妊娠为2.88%(46/1 598);腹腔妊娠急症型发生率最高,差异有统计学意义(P<0.01)。2 006例异位妊娠全部治愈,无死亡病例,治愈率为100.00%。结论:提高异位妊娠治愈率关键是重视临床症状、体征和辅助检查方法相结合,密切观察病情变化,及时准确选择正确的治疗方法。急症型病情凶险,医务工作者要有高度的责任心,决策果断及时并重视团队协作。
Objective: To investigate the incidence of ectopic pregnancy in recent 30 years, the incidence of type, including the number of cases of emergency type ectopic pregnancy, incidence characteristics and the incidence of the site. Methods: The data of 2 006 cases of ectopic pregnancy admitted from 1980 to 2009 were analyzed retrospectively. Results: ① The total number of ectopic pregnancy in 30 years was 2 006 cases, 76 105 pregnant women in the same period, the incidence was 2.64%. The incidence was on the rise: 0.31% (67/21 454) in 1980-1989, 1.31% (327/48899) in 1990-1999 and 5.42% (1612/29 752) in 2000-2009, with statistical differences Significance (P <0.01). ②2 006 cases of ectopic pregnancy by surgery and pathological examination of a total of 1642 cases, accounting for 81.85%; 364 cases of drugs and looking forward to treatment, accounting for 18.15%. ③ Surgical findings (laparotomy and laparoscopy) Category: tubal pregnancy accounted for 97.32% (1 598/1 642), ovarian pregnancy accounted for 1.04% (17/1 642), residual angle pregnancy accounted for 0.61% (10/1 642) , Accounting for 0.55% (9/1 642), accounting for 0.49% (8/1 642) for intrauterine pregnancy and tubal pregnancy, the difference was statistically significant (P <0.01). The incidence of acute ectopic pregnancy in 69 cases, the incidence was 4.20% (69/1 642); incidence and incidence of site relationship: abdominal pregnancy was 75.00% (6/8), residual angle pregnancy 40.00% (4/10), The incidence of ovarian pregnancy was 35.29% (6/17), that of cornual pregnancy was 22.22% (2/9), that of tubal pregnancy was 2.88% (46/1 598), and that of the emergency pregnancy was the highest (P <0.01). 2 006 cases of ectopic pregnancy were completely cured, no deaths, the cure rate was 100.00%. Conclusion: The key to improve the cure rate of ectopic pregnancy is to pay attention to clinical symptoms, signs and laboratory examinations combined with close observation of changes in condition, timely and accurate selection of the correct treatment. Emergency-type illness is dangerous, medical workers should have a high sense of responsibility, decisive decision-making timely and pay attention to teamwork.