本文選題：育齡期女性 + 不孕癥�。� 參考：《浙江大學(xué)》2017年碩士論文

【摘要】：目的:調(diào)查浙江省育齡期女性不孕癥患病率、流行現(xiàn)狀,探討不孕癥相關(guān)危險(xiǎn)因素,為不孕癥的預(yù)防和診治提供參考。方法:采用分層整群抽樣法,隨機(jī)抽取浙江省10個(gè)地區(qū)2000名育齡女性進(jìn)行橫斷面研究。采用問卷調(diào)查、體格檢查、婦科檢查、經(jīng)陰道B超檢查診斷和評估所有育齡女性的生殖健康狀況及不孕相關(guān)危險(xiǎn)因素。不孕癥的診斷標(biāo)準(zhǔn)以最新的美國生殖醫(yī)學(xué)學(xué)會(huì)(ASRM)[1]2015年制訂的指南為準(zhǔn)。計(jì)量資料采用均數(shù)±標(biāo)準(zhǔn)差(x±s)描述其集中和離散程度,在滿足方差齊性的條件下,計(jì)量資料采用t檢驗(yàn);計(jì)數(shù)資料中采用率和95%置信區(qū)間(95%CI)描述分布,二分類資料采用卡方檢驗(yàn);不孕癥的多因素分析采用二元logistic逐步回歸進(jìn)行分析。以P0.05認(rèn)為差異具有統(tǒng)計(jì)學(xué)意義。結(jié)果:1.本次調(diào)查最終獲得有效問卷1953份,其中確診為不孕癥患者93名,總患病率為4.76%,其中原發(fā)不孕占22.6%(21/93),繼發(fā)不孕占77.4%(72/93)。2.從不孕癥病因來看:輸卵管因素26.9%(25/93),排卵障礙24.7%(23/93),子宮因素占8.6%(8/93),子宮內(nèi)膜異位癥占5.4%(5/93),輸卵管合并排卵障礙占2.2%(2/93),男性因素占2.2%(2/93),不明原因占11.8%(11/93),另外還有一部分不孕癥患者在此次調(diào)查中符合不孕癥診斷,但無生育要求,目前無就醫(yī)意愿,占18.3%(17/93)。3.從結(jié)婚年齡來看:≥30歲結(jié)婚組不孕癥的患病率最高,為10.3%,高于25-29歲結(jié)婚組5.8%及≤24歲結(jié)婚組3.2%(p0.05)。4.單因素分析不孕癥的影響因素表明:結(jié)婚年齡晚,初潮年齡早,城市戶口,腦力勞動(dòng)者,女性學(xué)歷高,丈夫?qū)W歷高,月經(jīng)不規(guī)律,月經(jīng)稀發(fā)(周期38天),月經(jīng)量過少(5ml),有支原體感染病史,子宮體積小,體重超重(BMI≥25)是女性患不孕癥的危險(xiǎn)因素(P0.05)。5.多因素分析不孕癥的影響因素。根據(jù)單因素分析的結(jié)果把有意義的結(jié)果納入二元logistic逐步回歸方程,進(jìn)一步證明:結(jié)婚年齡晚,初潮年齡早,月經(jīng)不規(guī)律(月經(jīng)稀發(fā)),月經(jīng)量過少(5ml),有支原體感染史,體重超重(BMI≥25)是浙江省育齡期女性不孕癥的危險(xiǎn)因素(p0.05)。結(jié)論:1.本研究顯示浙江省育齡期女性的不孕癥患病率為4.76%。2.浙江省育齡期女性不孕癥的病因以輸卵管因素和排卵障礙為主,其次為子宮因素、子宮內(nèi)膜異位癥、男性因素及不明原因。3.結(jié)婚年齡晚,初潮年齡早,月經(jīng)不規(guī)律(月經(jīng)稀發(fā)),月經(jīng)量過少(5ml),有支原體感染史,體重超重(BMI≥25)為育齡期女性不孕癥的危險(xiǎn)因素。4.提倡適齡結(jié)婚,適齡生育,積極完善孕前檢查,月經(jīng)不規(guī)律應(yīng)積極就診,控制合理體重。
[Abstract]:Objective: to investigate the prevalence and prevalence of infertility among women of childbearing age in Zhejiang Province, and to explore the risk factors related to infertility in order to provide reference for the prevention, treatment and diagnosis of infertility. Methods: 2000 women of childbearing age in 10 regions of Zhejiang province were randomly selected by stratified cluster sampling. The reproductive health status and risk factors of infertility were diagnosed and evaluated by questionnaire, physical examination, gynecological examination and transvaginal ultrasonography. The diagnostic criteria for infertility are based on the latest guidelines developed by the American Society of Reproductive Medicine (ASRM) in 2015. The mean 鹵standard deviation (x 鹵s) was used to describe the degree of concentration and dispersion. Under the condition of homogeneity of variance, t test was used to measure the data, and the rate and 95% confidence interval (95% CI) were used to describe the distribution in the counting data. Two classification data were analyzed by chi-square test, and the multivariate analysis of infertility was carried out by binary logistic stepwise regression. P0.05 thought the difference was statistically significant. The result is 1: 1. 1953 valid questionnaires were obtained, of which 93 were diagnosed as infertility, and the total prevalence rate was 4.76. Primary infertility accounted for 22.6% (21 / 93) and secondary infertility 77.4% (72 / 93). Cause of infertility: oviduct factor 26.9% (25 / 93), ovulation disorder 24.7% (23 / 93), uterine factor 8.6% (8 / 93), endometriosis 5.4% (5 / 93), fallopian tube complicated ovulation disorder 2.2% (2 / 93), male factor 2.2% (2 / 93), unknown cause 11.8% (1193). In accordance with the diagnosis of infertility in this investigation, But no fertility requirements, currently no desire to seek medical care, accounting for 18.3% (17 / 93) .3. According to the age of marriage, the incidence of infertility was the highest in the group of 鈮，

本文編號(hào)：2112161