醋酸甲羟孕酮针剂在哺乳期妇女避孕中的应用

Application of Depot Medroxyprogesterone Acetate in Breast-Feeding Women

目的:寻求哺乳期妇女运用醋酸甲羟孕酮(DMPA)避孕的最佳投药剂量。方法:将受试对象分为DM-PA组和未使用DMPA的产后哺乳期妇女,排除不符合研究标准者,纳入研究对象共319例,DMPA150mg组83例,100mg组80例,75mg组81例,未使用DMPA组75例,DMPA组每3个月深部肌肉注射1次,共4次。结果:非DMPA组避孕成功率为80.00%,150mg与100mgDMPA组避孕成功率均为100.00%,75mg组成功率为98.77%,3个不同剂量DMPA组避孕成功率均显著高于非DMPA组(P<0.01),但3组间差别无统计学意义(P>0.05)。发生的副反应中,点滴出血75mg组为4.94%,明显低于150mg组的16.87%(P<0.05)和100mg组的10.00%(P<0.05)。结论:75mgDMPA用于哺乳期妇女避孕不影响其有效性,且可减少副反应发生率,可作为我国哺乳期妇女运用DMPA避孕的最佳投药剂量。

Objective：To explore the optimal dose of depot medroxyprogesterone acetate （DMPA） for the contraception of breast-feeding women. Methods： A total of 319 subjects were assigned into 150, 100, and 75 mg DMPA injection groups and non-DMPA injection group respectively. DMPA was injected four times, once every three months, in DMPA groups. Results： Both 150 mg and 100 mg DMPA groups had 100.00% successful rate, while 75 mg DMPA group had 98.77% successful rate of contraceptive, and the successful rates of all the three DMPA groups had no difference but were higher than that of the non-DMPA group （P0.01）. A small amount of vaginal bleeding occurred in 4.94% of 75 mg DMPA group, which is significantly lower than in 150 mg group （16.87%）（P0.05） and in 100 mg group （10.00%）（P0.05）. Conclusion： DMPA at a dosage of 75 mg is recommended to Chinese breast-feeding women in contraception with less side-effects.