涟水地区300例不孕不育患者病因调查与分析(1)
【摘要】 目的：通过分析涟水地区不孕不育症的主要病因分布及影响因素，探讨如何在基层卫生和计划生育服务机构开展不孕不育初诊和治疗工作。方法：对2014年1月-2015年6月在涟水县计划生育指导站不孕不育门诊就诊的300例不孕不育夫妇进行不孕不育的病因调查。结果：300例夫妇中原发不孕184例(61.3%)，继发不孕116例(38.7%)。不孕原因中女方因素201例(67.0%)，男方因素59例(19.7%)，男女双方因素30例(10.0%)，原因不明10例(3.3%)。女性不孕原因以输卵管因素为主，其次是排卵因素；而男性不育以少精、弱精症居首，其次为死精、无精症。结论：应加强女性妇科相关疾病的防治和男性生精功能障碍的机制研究。应尽快在基层建立不孕不育症专科门诊，为不孕不育症患者提供技术服务，向不孕不育症夫妇普及生理卫生科学知识，做到早发现、早治疗。
【关键词】 不孕不育； 病因； 调查
【Abstract】 Objective：To analyze the distribution of primary cause and impact factors of infertility in Lianshui district，in order to explore how the diagnosis and treatment of infertility cases are carried out among the primary-level health and family planning agencies.Method：From January 2014 to June 2015，300 infertile couples who admitted to family planning clinics of Lianshui district were investigated by standardized questionnaire.Result：In 300 couples，184 couples(61.3%) were primary infertility and 116 couples (38.7%) were secondary infertility.There were 201 couples(67.0%) of female infertility，59 couples(19.7%) of male infertility，30 couples(10.0%) of combined infertility and 10 couples(3.3%) of unexplained infertility.Primary causes of female infertility were fallopian tube problems，then ovulatory problems.The causes of male infertility with oligospermia and asthenospermia first，followed by dead sperm and azoospermia.Conclusion：Strengthening the prevention and treatment of gynecological disease and the mechanism study on male spermatogenesis dysfunction is necessary.Specialty clinic of infertility should be established at primary-level as soon as possible，to provide health education and related services for infertility patients，to spread the knowledge of physiology and health science to infertile couples，ensure early detection and early treatment.
【Key words】 Infertility； Disease cause； Investigation
First-author’s address：Jiangsu Institute of Planned Parenthood Research，Nanjing 210036，China
doi：10.3969/j.issn.1674-4985.2016.30.014
据2012年《中国不孕不育现状调研报告》显示，我国育龄人群中不孕不育率已经高达12.5%。随着人们生活方式的改变、性传播疾病的不断增加，不孕症的发病率呈逐年上升的趋势[1]，对不孕不育原因的分析一直是社会和医疗界高度关注的问题。发病率升高位居第一位的原因是妇女婚姻和生育年龄的延迟。世界各国因为文化、地理、宗教和种族的不同，其不孕不育症的病因构成和分布，以及治疗策略和预防干预都存在差异。我国的生育状况和不孕不育的现状和趋势、年龄和病因的分布、治疗和预后的现状等问题，关系我国制定人口政策和医疗卫生政策的依据。因此研究不孕不育的病因和相关影响因素对于不孕不育症的防治，具有重要意义。现报道如下。
1 对象与方法
1.1 对象 2014年1月-2015年6月到涟水县计划生育指导站不孕不育门诊就诊的不孕不育的夫妇300例，平均不孕年限(3.92±3.81)年，最短1年，最长21年，原发不孕184例(61.3%)，继发不孕116例(38.7%)。
1.2 调查方法 使用自行设计的“不孕不育病因评估调查表”进行问卷调查，收集患者夫妇双方年龄、不孕年限、月经史、孕产史、性生活史，既往感染史、手术史，全身的常规体检包括：身高、体重指数、发育营养情况、皮肤和四肢等特征。检查乳房发育情况，寻找男性化多毛，亦属内分泌常规检查和有关不孕症的特殊检查包括：盆腔的双合诊和三合诊检查、妇科超声检查(腔内超声)、女方排卵监测、子宫输卵管通液/造影、精液分析记录等及宫腔镜、腹腔镜、性交后试验、精子特殊染色和精子功能检查等。, 百拇医药(王丽娟 孙庆 施雯慧 查树伟 吕年青 许豪勤)
【关键词】 不孕不育； 病因； 调查
【Abstract】 Objective：To analyze the distribution of primary cause and impact factors of infertility in Lianshui district，in order to explore how the diagnosis and treatment of infertility cases are carried out among the primary-level health and family planning agencies.Method：From January 2014 to June 2015，300 infertile couples who admitted to family planning clinics of Lianshui district were investigated by standardized questionnaire.Result：In 300 couples，184 couples(61.3%) were primary infertility and 116 couples (38.7%) were secondary infertility.There were 201 couples(67.0%) of female infertility，59 couples(19.7%) of male infertility，30 couples(10.0%) of combined infertility and 10 couples(3.3%) of unexplained infertility.Primary causes of female infertility were fallopian tube problems，then ovulatory problems.The causes of male infertility with oligospermia and asthenospermia first，followed by dead sperm and azoospermia.Conclusion：Strengthening the prevention and treatment of gynecological disease and the mechanism study on male spermatogenesis dysfunction is necessary.Specialty clinic of infertility should be established at primary-level as soon as possible，to provide health education and related services for infertility patients，to spread the knowledge of physiology and health science to infertile couples，ensure early detection and early treatment.
【Key words】 Infertility； Disease cause； Investigation
First-author’s address：Jiangsu Institute of Planned Parenthood Research，Nanjing 210036，China
doi：10.3969/j.issn.1674-4985.2016.30.014
据2012年《中国不孕不育现状调研报告》显示，我国育龄人群中不孕不育率已经高达12.5%。随着人们生活方式的改变、性传播疾病的不断增加，不孕症的发病率呈逐年上升的趋势[1]，对不孕不育原因的分析一直是社会和医疗界高度关注的问题。发病率升高位居第一位的原因是妇女婚姻和生育年龄的延迟。世界各国因为文化、地理、宗教和种族的不同，其不孕不育症的病因构成和分布，以及治疗策略和预防干预都存在差异。我国的生育状况和不孕不育的现状和趋势、年龄和病因的分布、治疗和预后的现状等问题，关系我国制定人口政策和医疗卫生政策的依据。因此研究不孕不育的病因和相关影响因素对于不孕不育症的防治，具有重要意义。现报道如下。
1 对象与方法
1.1 对象 2014年1月-2015年6月到涟水县计划生育指导站不孕不育门诊就诊的不孕不育的夫妇300例，平均不孕年限(3.92±3.81)年，最短1年，最长21年，原发不孕184例(61.3%)，继发不孕116例(38.7%)。
1.2 调查方法 使用自行设计的“不孕不育病因评估调查表”进行问卷调查，收集患者夫妇双方年龄、不孕年限、月经史、孕产史、性生活史，既往感染史、手术史，全身的常规体检包括：身高、体重指数、发育营养情况、皮肤和四肢等特征。检查乳房发育情况，寻找男性化多毛，亦属内分泌常规检查和有关不孕症的特殊检查包括：盆腔的双合诊和三合诊检查、妇科超声检查(腔内超声)、女方排卵监测、子宫输卵管通液/造影、精液分析记录等及宫腔镜、腹腔镜、性交后试验、精子特殊染色和精子功能检查等。, 百拇医药(王丽娟 孙庆 施雯慧 查树伟 吕年青 许豪勤)