3种节育器在农村推广使用的成本效果分析

Cost-effectiveness analysis of three kinds of intrauterine device in rural areas

目的了解元宫环、吉尼环、爱母环在农村推广的可接受性、效果和成本。方法收集服务人员和放置对象对3种节育器的评价意见,随访应用效果,并进行成本效果分析。结果经随访半年累积带环妊娠发生率:爱母环为5.88%,其余环均为0;累积取出率:爱母环为11.76%,T铜环3.33%,其余为0;但月经紊乱发生率、白带异常发生率元宫环分别为18.18%和17.39%,均高于其它环。在使用评价上,放置时疼痛率以元宫环和吉尼环较高,放置后出血天数和休息天数以爱母环较高,不满意率和放置技术掌握难度:元宫环高于T铜环。与T铜环相比,每100名妇女使用吉尼环、爱母环、元宫环1年可节约社会成本分别为1225、1032、764元以上。结论3种节育器均存在一些不足,但在成本效果上优于T铜环,值得进一步扩大推广。

Objective To evaluate acceptance, cost and effectiveness ratios of three kinds of intrauterine device （IUD） ： Yuangong IUD, GyneFix IUD and MCu IUD applied in rural areas. Methods The opinions from both users and technicians were collected, and the cost- effectiveness ratios of these IUD were also evaluated and compared. Results The cumulative pregnancy rate with IUD placed for half a year was 5.88% for MCu IUD and 0 for the other IUDs. The cumulative rate of IUD-withdrawing was 11.76% for MCu IUD, 3.33% for TCu IUD and 0 for Yuangong IUD and GyneFix IUD. But side-effects rate of Yuangong IUD was higher than that of the others（ 18.18% and 17, 39% for menstrual disorder and leucorrheal abnormality, respectively） The post-placement bleeding days and rest days of the women with Yuangong IUD was longer. The unsatisfactory rate of Yuangong IUD were higher than that of Tcu IUD and the placement difficulty was harder than that of Tcu IUD. By cost-effectiveness analysis, as compared with Tcu IUD, the saved cost per 100 women per 1 year of GyneFix IUD, MCu IUD and Yuangong IUD were more than 1 225 yuan RMB, 1 032 yuan RMB and 764 yuan RMB. Conclusion Ahhough these three IUDs have their disadvantages, they are superior to TCu IUD in cost-effectiveness, so they are worthy to be popularized in rural areas.