Mueller B A, Daling J R, Moore D E, Weiss N S, Spadoni L R, Stadel B V, Soules M R
N Engl J Med. 1986 Dec 11;315(24):1506-8. doi: 10.1056/NEJM198612113152402.
We studied the importance of a history of appendectomy for appendicitis in 279 women with laparoscopically or surgically diagnosed tubal infertility and a control group of 957 fertile women. After controlling for the effects of age, use of an intrauterine device for contraception, a history of pelvic inflammatory disease, and other potential confounding variables, we found that no excess risk of tubal infertility was associated with a simple appendectomy without rupture. However, when the operation was reportedly for a ruptured appendix, the relative risk of tubal infertility was 4.8 (95 percent confidence interval, 1.5 to 14.9) for women who had never been pregnant and 3.2 (95 percent confidence interval, 1.1 to 9.6) for women with one or more previous pregnancies. We conclude that the early diagnosis and treatment of suspected appendicitis in girls and women of reproductive age may reduce the incidence of tubal infertility resulting from the sequelae of a ruptured appendix.
我们研究了279例经腹腔镜或手术诊断为输卵管性不孕的女性以及957例可育女性组成的对照组中，阑尾切除术史对于阑尾炎的重要性。在控制了年龄、使用宫内节育器避孕、盆腔炎病史及其他潜在混杂变量的影响后，我们发现单纯性阑尾切除术且未发生破裂与输卵管性不孕的额外风险无关。然而，据报告手术是针对破裂阑尾时，从未怀孕女性的输卵管性不孕相对风险为4.8（95%置信区间为1.5至14.9），有一次或多次既往妊娠女性的相对风险为3.2（95%置信区间为1.1至9.6）。我们得出结论，对育龄期女孩和女性疑似阑尾炎进行早期诊断和治疗，可能会降低因阑尾破裂后遗症导致的输卵管性不孕的发生率。
