| Objective:By analyzing the clinical data of nonparous women oviduct and ovarian lesions,explore the nonparous women oviduct and ovarian disease pathogenesis situation and trend,the change of related factors,clinical characteristics and treatment of mode selection of clinical research,to provide clinical data for the prevention,standardization and individual accurate diagnosis and treatment of oviduct and ovarian lesions of nonparous women and better maintenance of reproductive health.Methods:From July 2016 to June 2019,3844 patients aged less than 45 years who were admitted to the first hospital of Bethune of Jilin University for gynecological treatment due to oviduct and ovarian lesions and had complete clinical data and reliable information were collected,among which a total of 1979 female patients with oviduct and ovarian lesions who had not given birth.Retrospective analysis and group control method were used to compare and analyze the clinical data characteristics of patients with oviduct and ovarian lesions that had not given birth and those with oviduct and ovarian lesions that had given birth.Results:1.Investigation and analysis of the incidence status and incidence trend of oviduct and ovarian lesions in nonparous women1)51.84%(1979 cases)of 3844 young female patients with oviduct and ovarian lesions did not give birth.Among the nonparous women with oviduct and ovarian lesions,1797 patients ?35years old accounted for 90.80%,and 1229 patients aged 21-30 years old accounted for 62.10%.In addition,265 patients ?20 years old accounted for 13.39%,and 182 patients > 35 years old accounted for 9.20%.The childbearing group mainly appeared in the age group of > 35 years old,accounting for 58.44%(1090/1865),and there was a significant difference between the two groups in the high-incidence age group.2)828 cases of female oviduct lesions accounted for 41.84%,among which 736 cases ?35years old accounted for 88.89%;60.56% of the 1151 cases had ovarian lesions in women who had not given birth,among which 1061 cases were less than or equal to 35 years old,accounting for92.18%.The difference between the two groups was significant(P < 0.05).3)the incidence rate of oviduct and ovary lesions in nonparous women was 14.85%,16.88% and 19.75% respectively in the three years,which was much higher than the increase rate of the childbearing group,indicating that the number of patients with oviduct and ovary lesions in nonparous women was increasing year by year.In particular,the rate of the nonparous women with oviduct lesions was 15.50%,17.68% and 21.44%,respectively,during the 3-year period,showing a more obvious upward trend compared with the childbearing group.2.Investigation and analysis of the correlation between salpinx and ovary lesions and marital and reproductive status of nonparous women1)there were 431 cases of infertility in 1979 female patients with salpinx and ovarian lesions,accounting for 21.78%,of which 281 cases had salpinx lesions,accounting for 65.20%,and33.94%(281/828)of those with salpinx lesions had been diagnosed as infertility.Infertility accounted for 34.80% of the 150 cases with ovarian lesions,while infertility was only diagnosed in 13.03%(150/1151)of the patients with ovarian lesions.The composition of oviduct lesions in infertile patients was significantly higher than that in ovarian lesions(P < 0.05).2)among the 1979 patients with nonparous salpinx and ovary lesions,549 were unmarried,accounting for 27.74%,of which 60.11% had sexual life.In the married group,there were 1430cases(72.26%),among which 30.14%(431/1430)were infertile,and 69.86% were incomplete birth(contraception).In the nonparous unmarried group,60.11%(330/549)of the sexually active contraceptive patients were significantly higher than the 39.89%(219/549)of the non-sexually active patients,suggesting that sexual life is a very important factor in the development of oviduct and ovary lesions.3.Comparison of abnormal pregnancy and abortion status in nonparous patients with tubal lesions1)in the nonparous tubal pregnancy patients,121 cases of unmarried sexual life group,69.42% had a history of abortion,14.05% had a history of ectopic pregnancy;Among the 348 married patients,46.26% had a history of miscarriage and 7.47% had a history of ectopic pregnancy.That is,the rate of history of abortion and ectopic pregnancy in the unmarried sexual life group was significantly higher than that in the married group,with significant difference between the two groups(P < 0.05).2)among the 819 patients with benign tubal lesions,784 were sexually active,of whom 145 were unmarried,accounting for 18.49%(145/784);Unmarried women accounted for 25.80%(121/469)of the cases with nonparous tubal pregnancy.Among 145 unmarried patients with benign tubal lesions,121 was tubal pregnancy,accounting for 83.45%,higher than 54.46%(348/639)of married patients with tubal pregnancy,X2=43.306,P=0.000.4.Changes in the types and clinical characteristics of oviduct and ovary lesions in nonparous women1)tubal pregnancy is the pathological change with the highest incidence rate of benign tubal lesions in the non-fertile and the fertile,reaching 57.27%(469/819)and 55.37%(376/679)of the cases in this group,respectively;The second was hydrosalpinx and pus accumulation(25.03% and27.54%,respectively).Other cases were mesosalpinx cyst,fallopian tube obstruction and abnormal fallopian tube development.By chi-square test and analysis,there was no statistical difference in the pathological types of benign tubal lesions between those who had not given birth and those who had given birth.Among the patients with fallopian tube lesions,28.50% of the nonparous patients had no obvious first symptoms.Other main symptoms included vaginal bleeding with abdominal pain(29.83%),abdominal pain with abdominal distension(21.74%)and vaginal bleeding(18.24%).Vaginal bleeding with abdominal pain(32.41%)and abdominal pain with abdominal distension(27.62%)were higher than those without birth(P < 0.05).In the group with nonparous tubal lesions,pelvic inflammation was associated with 38.05%,uterine fibroids 10.02%,adenomyosis 2.17%,and cervical lesions 1.45%.The patients who had given birth were combined with pelvic inflammation 28.93%,uterine fibroids 23.40%,adenomyosis 13.37%,and cervical lesions 3.95%.The rates of other gynecological diseases were significantly different between the nonparous patients and the childbearing patients.Pelvic inflammation was more common in patients who had not given birth,and adenomyosis and uterine fibroids were more common in patients who had given birth,P=0.000.2)the main pathological types of ovarian lesions in nonparous patients were ovarian endometriosis cyst(34.19%)and mature teratoma(29.99%),which were higher than those in the childbearing group(29.44% and 22.11%).Ovarian serous cystadenoma(16.32%)and ovarian simple cyst(15.29%)in the childbearing patients were higher than those nonparous patients,with significant difference between the two groups(P < 0.01).Mature teratomas(41.30%)in unmarried asexual patients were higher than those in sexually active patients(26.49%)(P < 0.01).Nearly half of the patients with ovarian lesions had no obvious clinical symptoms.In the ovarian disease group,the combination of nonparous patients with pelvic inflammation was 15.20%,with uterine fibroids of 10.77%,adenomyosis of 4.00%,and cervical lesions of1.13%.Fibroids,adenomyosis,pelvic inflammation and cervical lesions accounted for 22.43%,16.40%,7.31% and 2.29% of the patients who had given birth.The difference between the two groups was significant(P=0.000).3)oviduct and ovarian malignant tumor cases accounted for 2.63% of the patients who had not given birth,and 9.01% of the patients who had given birth,showing a significant difference between the two groups(P < 0.05).Among them,malignant ovarian lesions accounted for 13.51%of the patients who had given birth,and 3.82% of the patients who had not given birth,showing a significant difference between the two groups(P < 0.01).5.Analysis on the treatment options of nonparous women with oviduct and ovarian lesions1)the selection of treatment options for the oviduct lesions of nonparous women Laparoscopic surgery was performed on 71.98%(596/828)of the patients who had not given birth to oviduct lesions,and 67.59%(465/688)of the patients who had given birth to oviduct lesions.Conservative treatment was given to 17.39%(144/828)of the patients without childbearing oviduct disease and 12.94%(89/688)of the patients with childbearing oviduct disease.The patients without childbearing oviduct lesions were treated with radical therapy62.44%(517/828),and the childbearing group was treated with radical therapy 79.21%(545/688).There was a significant difference in the choice of treatment plan between the two groups,P=0.000.2)treatment options for ovarian diseases of nonparous women Among the patients with ovarian lesions,66.03% who had not given birth,51.40% who had given birth received laparoscopic conservative surgery,23.98% who had not given birth received conservative laparotomy,and 21.16% who had given birth received radical laparotomy.There was a statistical difference in the treatment methods between the two groups,P=0.000.For the nonparous patients with ovarian endometriosis cyst,66.76%(239/358 cases)underwent laparoscopic conservative surgery,26.26%(94/358 cases)underwent laparotomy conservative surgery,and 25 cases underwent radical laparotomy.Among the nonparous patients with mature teratoma of ovary,73.57%(231/314)underwent laparoscopic conservative surgery,23.25%(73/314)underwent laparotomy conservative surgery,2.54%(8/314)underwent laparotomy radical surgery,and 2 cases underwent laparoscopic radical surgery.Conclusion:1.Nonparous women are the main patients with oviduct and ovary lesions,and the incidence rate has been increasing year by year.2.The rate of oviduct lesions in nonparous infertile women was significantly higher than that of ovarian lesions.3.Fallopian pregnancy accounts for the first place of oviduct lesions in nonparous women,and the rate in unmarried sexual life women is higher.4.Ovarian lesions in nonparous women are mainly ovarian endometriosis cysts,while mature teratomas in unmarried women are more common.5.Laparoscopic surgery is the first choice for nonparous women with oviduct and ovary lesions,and the treatment tends to be conservative. |
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