| Objective: To provide clinical evidence for the prevention and clinical treatment of ectopic pregnancy in the nonparou women, and to provide more humanized, standardized and individualized treatment,the clinical data of nonparous women with ectopic pragnancy was retrospectively reviewed to summary the incidence trend of ectopic pragnancy, related risk factors,clinical characteristics, outcome and the change of operation mode.Methods: All data was collected from 726 ectopic pragnancy patients treated in the First Hospital of Jilin University from January 1st 2013 to December 31 th 2015, among them,324 patients with ectopic pregnancy have none child.And carry out a retrospective analysis and grouping with control for comparision to analyze the clinical data using chi-square test and nonparametric test as statistical methods.Results:1. 726 ectopic pragnancy patients was treated in the First Hospital of Jilin University from January 1st 2013 to December 31 th 2015, among them, 324 patients was nonparous, the proportion is as high as 44.63%. In generally,the incidence of ectopic pregnancy in general is on the rise for the last three years,,and the proportion of nonparous patients with ectopic pregnancy has a rising trend year by year.2. The height of the occurrence of the nonparous ectopic pregnancy was 25~29 years old,130 cases, accounting for 40.12%; followed by 20~24 years old and 30~34 years old,respectively, accounted for 23.95% and 22.46%; of which 3.70% of the nonparou ectopic pregnancy patients were less than 19 years old. The main age of the occurrence of ectopic pregnancy in woman who had given borth was 25~39 years old, a total of 327 cases,accounted for 81.34%, of which 30~34 years of age as the peak age. The peak age of the ectopic pregnancy was 5 years earlier than that of the first birth, X2=134.200, P < 0.05.3. There was 103 cases(31.79%)unmarried nulliparous women with ectopic pregnancy,221 married patients(68.21%), 402 cases have been fertility ectopic pregnancy patients are all married; Among 324 cases of nonparous ectopic pregnancy, rural population(66.98%) was significantly higher than that in urban areas(33.02%);Students or industrial workers in nonparous ectopic pregnancy patients was significantly more than fertility ectopic pregnancy(P < 0.05).4. Nonparous ectopic pregnancy occurs most often in the oviduct ampulla(81.43%) and subsequently followed as: tubal isthmus(9.28%), between the oviduct and quality department(4.22%), tubal umbrella end in 5 cases(2.11%) and ovarian(2.11%), and has female fertility ectopic pregnancy compared no significant statistic difference(X2=2.200, P > 0.05). The percentage of ruptured ectopic pregnancy in nonparous ectopic pregnancy was significantly higher than that in the fertility ectopic pregnancy(X2=8.378, P < 0.05).5. 72.53% of the nonparous patients with ectopic pregnancy had abdominal pain symptoms, more than in fertility patients(56.72%),X2=19.421, P < 0.05. 18.83% of the nonparous patients have lower abdominal anus abdominal bulge symptoms, significantly higher than the fertility women with ectopic pregnancy(8.21%),X2=17.946, P < 0.05. 96.91%of the nonparous patients with ectopic pregnancy have vaginal bleeding, significantly higher than the fertility women with ectopic pregnancy(63.68%), X2=117.441, P < 0.05.6. Nonparous patients with ectopic pregnancy with HCG value in less than 500IU/L,proportion of or >10000IU/L occupied were significantly higher than fertility patients,whose HCG value are more concentrated in the 500-2000IU/L.7. For ultrasonic appearanc,the proportion of nonparous pationts whose package block bigger than 5cm was significantly greater than that of the fertility patients. 10.80%(35 cases)nonparous pationts could be detected with lesions tube shoots, fetal hear in ultrasound examination,significantly higher than fertility patients with ectopic pregnancy 6.47%(X2=4.380, P < 0.05)8. The intraperitoneal bleeding volum of nonparous patients with ectopic pregnancy mostly between 100-500 ml.9. The number of nonparous patients with ectopic pregnancy decreased gradually with the increase of the number of pregnancies and the number of abortions,and the number of previous pregnancy or abortion was significantly less than the fertility patients(P < 0.05).10. The rate of nulliparous women with ectopic pregnancy, abdominal surgery, history of tubal embryo transfer were: 21.60%, 3.09%, 9%, respectively. Compared with fertile ectopic pregnancy, pelvic or abdominal operation historywas significantly lower(X2=138.130, P <0.05), while the proportion of embryo transfer significantly higher proportion(X2=11.096, P< 0.05), tubal hydrotubation both had no significant difference.11. Pelvic inflammatory disease(including tuberculosis, endometrial endometriosis,uterine cavity disease, uterus tumor, ectopic pregnancy history, infertility in childless ectopic pregnancy incidence was 45.37%, 4.32%, 0.62%, 6.17% and 8.02% and 8.02%respectively.Compared with the fertility, the incidence of infertility was significantly higher(X2=19.305, p<0.05), and other related history, there was no statistical difference between the two.12. Laparoscopic treatment accounted for 64.05% in nulliparous women with ectopic pregnancy,of which, the vast majority of patients underwent laparoscopic radical surgery(89.68%).The proportion of patients who received laparoscopic conservative surgery was11.73%, which was significantly higher than that of the(2.55%), P < 0.05.Conclusion:1. The childless women in patients with ectopic pregnancy rate has increased year by year and younger.2. The infertility and embryo transfer are the risk factors for the occurrence of ectopic pregnancy.3.The nulliparous women with ectopic pregnancy was more in rural areas than in the city.4. The rate of rupture of tubal pregnancy is higher in nulliparous patients than that of the patients who had been given birth. |
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