本文選題：女性不孕癥 + 病因��； 參考：《山東大學(xué)》2014年碩士論文

【摘要】：[研究目的] 通過對(duì)女性不孕癥的病因及相關(guān)影響因素的調(diào)查結(jié)果進(jìn)行統(tǒng)計(jì)分析,探討不孕癥可能的主要病因及高危影響因素,為預(yù)防及診治不孕癥提供參考依據(jù)。 [研究對(duì)象] 1.本研究采用醫(yī)院為基礎(chǔ)1：1匹配病例對(duì)照研究,選擇2013.5—2014.1間就診于濟(jì)南某三級(jí)甲等醫(yī)院生殖醫(yī)學(xué)中心并明確診斷為不孕癥的女性患者216例為病例組。 2.選擇同期就診于同一醫(yī)院婦產(chǎn)科生育功能正常的女性216例作為對(duì)照組,其中包括自然而無任何人為干預(yù)的情況下受孕的孕產(chǎn)婦、意愿外或避孕失敗而懷孕行人工流產(chǎn)術(shù)者。 [研究方法] 1.研究方法采用病例對(duì)照研究,以醫(yī)院就診者為研究人群,其中不孕女性為病例組,能自然正常懷孕者為對(duì)照組。 2.數(shù)據(jù)資料是通過對(duì)每位研究對(duì)象進(jìn)行不孕癥的臨床系統(tǒng)檢診、填寫女性健康調(diào)查問卷的方法獲取。 2.1臨床檢診對(duì)病例組、對(duì)照組均采集病史、系統(tǒng)檢診等8項(xiàng)檢查項(xiàng)目。 2.2調(diào)查問卷病例組、對(duì)照組均認(rèn)真填寫“女性健康狀況調(diào)查問卷”,問卷包括7方面內(nèi)容共126個(gè)問題。 3.統(tǒng)計(jì)分析 (1)應(yīng)用EPidata3.1建立數(shù)據(jù)庫,應(yīng)用SPssl6.0軟件進(jìn)行分析描述。 (2)應(yīng)用構(gòu)成比來描述致病因素的構(gòu)成。 (3)利用條件Logistic回歸模型,對(duì)各因素進(jìn)行單因素分析。 (4)將篩選出的因素導(dǎo)入Logistic回歸模型,進(jìn)行多因素分析。 [結(jié)果] 本調(diào)查共獲取有效問卷432份,其中女性不孕患者、女性正常生育能力者各216份。分析結(jié)果如下： 1.病因構(gòu)成比分析：女性不孕的主要病因排序依次為輸卵管類疾病(41.3%)、卵巢類疾病(32.4%)、免疫性不孕類疾病(8.3%)、不明原因類疾病(5.1%)、子宮類疾病(4.6%)、陰道炎癥(4.6%)、內(nèi)分泌疾病(2.3%)、遺傳病(1.4%)。 輸卵管類不孕主要為輸卵管梗阻性不孕,其主要致病因素為：性傳播性疾病、婦科炎癥(非特異性)、子宮內(nèi)膜異位癥。 卵巢類不孕主要為卵巢排卵障礙性不孕,其主要病因?yàn)椋憾嗄衣殉簿C合征、卵巢巧克力樣囊腫、婦科炎癥(非特異性)。 2.單因素分析結(jié)果：女性不孕病因影響因素中具有顯著性差異的因素如下： 2.1生物學(xué)因素中包括：婦科炎癥、月經(jīng)不規(guī)律、人工流產(chǎn)次數(shù)多、異位妊娠史、性交痛、痛經(jīng)、內(nèi)分泌疾病史、肝病、腫瘤、風(fēng)濕等免疫性疾病史、婦科手術(shù)史、甲狀腺疾病史、應(yīng)用藥物史(安定、激素類藥)、胃腸道疾病史等。 2.2社會(huì)因素 2.2.1基本情況因素包括：職業(yè)(農(nóng)民)、文化水平低、年齡大等。 2.2.2婚姻性生活因素包括：性伴侶人數(shù)多、第一次性交年齡過小、外陰陰道清洗頻繁、經(jīng)常經(jīng)期性生活、性生活滿意度低等。 2.2.3生活飲食習(xí)慣因素包括：經(jīng)常熬夜、睡前經(jīng)常使用手機(jī)、燙發(fā)頻繁、經(jīng)常飲酒、常使用電熱毯、吸煙、飼養(yǎng)寵物、常使用微波爐；經(jīng)常食用甜點(diǎn)煎炸食品、腌制食品、棉籽油等。 2.2.4心理因素包括：與父母關(guān)系緊張、夫妻關(guān)系不和諧、同事關(guān)系不融洽、心理壓力大、無助失望等。 2.3環(huán)境因素包括：同事吸煙多、近期住房裝修,經(jīng)常夜班作業(yè)、經(jīng)常接觸毒物、重金屬、農(nóng)藥等。 3.多因素分析結(jié)果：年齡(OR=34.979)、婦科炎癥(OR=2.688)、月經(jīng)不規(guī)律(OR=3.273)、第一次性交年齡小(OR=4.255)、性伴侶個(gè)數(shù)多(OR=2.396)、經(jīng)常食用甜點(diǎn)煎炸食品(OR=3.755)、熬夜(OR=2.801)、睡前使用手機(jī)(OR=2.814)、接觸毒物/重金屬/農(nóng)藥(OR=1.990)、心理壓力大(OR=3.067)等可能是女性不孕癥的高危因素。 [結(jié)論] 1.輸卵管梗阻性疾病及卵巢排卵障礙性疾病可能是導(dǎo)致女性不孕癥的主要疾病。 2.婦科炎癥、子宮內(nèi)膜異位癥、多囊卵巢綜合征等疾病是導(dǎo)致輸卵管梗阻性疾病及卵巢排卵障礙性疾病的主要病因,其間接地成為女性不孕的危險(xiǎn)因素。 3.年齡、第一次性交年齡小、性伴侶個(gè)數(shù)多、熬夜、心理壓力大、經(jīng)常食用甜點(diǎn)及煎炸食品、睡前使用手機(jī)等社會(huì)因素可能是導(dǎo)致女性不孕的危險(xiǎn)因素。 4.經(jīng)常接觸毒物、重金屬、農(nóng)藥等因素等可能是女性不孕癥的環(huán)境危險(xiǎn)因素。
[Abstract]:[research purposes]
Through the statistical analysis of the causes of female infertility and related factors, the main causes of infertility and the risk factors are discussed to provide reference for the prevention and treatment of infertility.
[object of study]
1. in this study, a case-control study based on a hospital based 1:1 matched case was used, and 2013.5 to 2014.1 were selected from the reproductive medical center of a class three class a hospital in Ji'nan and 216 cases of female patients diagnosed as infertility.
2. selected 216 women with normal reproductive function in the same hospital and obstetrics and gynecology in the same hospital as the control group, including pregnant and parturient women who were naturally pregnant without any intervention, and were pregnant with abortions without the intention or failure of contraception.
[research methods]
1. the case-control study was conducted in the study group. The patients in the hospital were the study group, and the infertile women were case group.
2. data is obtained through the systematic clinical diagnosis of infertility and the completion of the female health questionnaire.
2.1 clinical cases were collected from the case group and the control group by 8 items, including medical history, systematic examination and so on.
2.2 the questionnaire group and the control group were filled in the "women's health questionnaire". There were 126 questions in the questionnaire including 7 aspects.
3. statistical analysis
(1) using EPidata3.1 to build database, using SPssl6.0 software to analyze and describe.
(2) the composition of the application composition ratio to describe the pathogenic factors.
(3) using conditional Logistic regression model, single factor analysis was carried out on all factors.
(4) to import the screened factors into Logistic regression model and conduct multivariate analysis.
[results]
A total of 432 valid questionnaires were obtained, including 216 female infertile women and normal fertile women. The results are as follows:
1. factor analysis: the main causes of female infertility were fallopian tube disease (41.3%), ovarian disease (32.4%), immune infertility (8.3%), unexplained disease (5.1%), uterine disease (4.6%), vaginitis (4.6%), endocrine disease (2.3%), and hereditary disease (1.4%).
Tubal infertility is mainly oviduct obstructive infertility, and its main pathogenic factors are sexually transmitted diseases, gynecological inflammation (non-specific), endometriosis.
Ovarian infertility is mainly ovarian ovulatory infertility. The main diseases are polycystic ovary syndrome, ovarian chocolate like cyst and gynecological inflammation (non-specific).
2. univariate analysis: there are significant differences in the factors influencing female infertility.
2.1 biological factors include: gynecologic inflammation, irregular menstruation, many times of induced abortion, history of ectopic pregnancy, sexual pain, dysmenorrhea, history of endocrine disease, liver disease, the history of immune diseases such as tumor, rheumatism, gynecologic operation history, history of thyroid disease, history of application of drugs (andin, hormone drugs), and the history of gastrointestinal diseases.
2.2 social factors
2.2.1 the basic situation factors include: occupation (farmers), low educational level, age and so on.
2.2.2 sexual life factors include: the number of sexual partners, the first sexual intercourse age is too small, vaginal vaginal cleaning frequent, frequent menstrual life, sexual life satisfaction is low.
2.2.3 lifestyle factors include: often staying up late, regular use of mobile phones before bedtime, frequent perm, frequent drinking, frequent use of electric blankets, smoking, raising pets, often using microwave ovens, often eating dessert fried food, pickled food, cottonseed oil and so on.
2.2.4 psychological factors include: tension with parents, disharmony between husband and wife, lack of harmony among colleagues, psychological pressure, helpless disappointment, etc.
2.3 environmental factors include: colleagues smoking too much, recent housing renovation, frequent night shift operations, frequent exposure to poisons, heavy metals, pesticides and so on.
3. multiple factors analysis: age (OR=34.979), gynecologic inflammation (OR=2.688), irregular menstrual (OR=3.273), the first sexual intercourse age (OR=4.255), sex partner more (OR=2.396), often eating dessert fried food (OR=3.755), staying up (OR=2.801), using cell phone (OR=2.814) before bedtime, exposure to poison / heavy metal / pesticide (OR=1.990), and psychological pressure (OR=3.067) etc. may be a high risk factor for female infertility.
[Conclusion]
1. Tubal Obstructive Diseases and ovarian ovulatory disorders may be the main cause of female infertility.
2. diseases such as gynecologic inflammation, endometriosis and polycystic ovary syndrome are the main causes of oviduct obstruction and ovarian ovulatory disorders, and earthing between them is a risk factor for female infertility.
The 3. age, the first sexual intercourse age, the number of sexual partners, staying up late, the psychological pressure, often eating dessert and fried food, the use of mobile phone before bedtime and other social factors may be a risk factor for female infertility.
4. exposure to poisons, heavy metals, pesticides and other factors may be environmental risk factors for female infertility.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R711.6

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 胡德芬,段煉,劉曉美;生殖道沙眼衣原體和解脲支原體感染119例分析[J];第三軍醫(yī)大學(xué)學(xué)報(bào);2001年12期

2 魏敏,景冬新,洛若愚,張蔚,吳秀芝,楊連第,陳昌源,魯敏;弓形蟲感染與輸卵管性不孕關(guān)系的探討[J];公共衛(wèi)生與預(yù)防醫(yī)學(xué);2005年04期

3 王娟;覃愛平;;子宮內(nèi)膜異位癥合并不孕的治療[J];中國(guó)計(jì)劃生育學(xué)雜志;2007年12期

4 王莉貞,劉霞,王麗萍;人工流產(chǎn)術(shù)后繼發(fā)不孕124例分析[J];浙江臨床醫(yī)學(xué);2003年02期

5 常笑雪;黃鸝;楊石強(qiáng);趙榮坡;張?chǎng)?;抗精子抗體和抗子宮內(nèi)膜抗體與人工流產(chǎn)后繼發(fā)不孕的關(guān)系[J];河南科技大學(xué)學(xué)報(bào)(醫(yī)學(xué)版);2007年02期

6 包文芳;黃文軍;;50例不孕婦女甲狀腺功能的檢測(cè)分析[J];青海醫(yī)藥雜志;2009年10期

7 丁穎;鄧成艷;孫正怡;何方方;郁琦;;子宮內(nèi)膜異位癥合并不孕患者期待處理后妊娠與控制性藥物刺激卵巢后妊娠情況分析[J];實(shí)用婦產(chǎn)科雜志;2009年01期

8 李桂榮,任瑞美,曹清松,王航;有機(jī)磷農(nóng)藥對(duì)作業(yè)女工健康的影響[J];中國(guó)工業(yè)醫(yī)學(xué)雜志;2000年06期

9 陳叔平,李潭,林艇,黃勁松,鹿敏;原發(fā)與繼發(fā)不育免疫因素的比較[J];生殖醫(yī)學(xué)雜志;2001年05期

10 楊華,李曉青;沙眼衣原體感染與女性不孕的關(guān)系[J];西安交通大學(xué)學(xué)報(bào)(醫(yī)學(xué)版);2003年05期

，

本文編號(hào)：1918618