流产后咨询与教育对意外妊娠行人工流产的未婚青少年干预效果

Evaluation of the effect of post-abortion counseling and education among unmarried abortion adolescents

目的 了解意外妊娠行人工流产的未婚青少年（简称：未婚人工流产青少年）对流产后咨询与教育（PACE）干预的需求,并评估PACE的干预效果.方法 2007年12月至2008年4月间对122例未婚人工流产青少年进行PACE干预（干预组）,同期因个人原因拒绝接受PACE干预的67例未婚人工流产青少年为未干预组.两组均于流产前进行PACE干预需求的调查,并于流产后1年进行避孕及意外妊娠情况调查.结果 184例（97.4%,184/189）研究对象表示愿意接受PACE干预;91例（48.1%,91/189）希望就医时进行干预;136例（72.0%,136/189）希望通过面对面咨询的方式进行PACE干预.干预组有101例（82.8%,101/122）接受了流产后1年的随访,随访期间有性生活但无生育要求者77例;未干预组有54例（81%,54/67）接受了流产后1年的随访,随访期间有性生活但无生育要求者41例.流产后1年,干预组与未干预组中分别有74%（57/77）和24%（10/41）的研究对象采用了有效的避孕措施,两组比较,差异有统计学意义（P〈0.01）;干预组中有1例（1%,1/77）出现再次意外妊娠,而未干预组中有4例（10%,4/41）发生意外妊娠,两组比较,差异也有统计学意义（P=0.034）.结论 绝大多数未婚人工流产青少年都有较强的PACE干预需求;PACE干预可显著提高未婚青少年有效避孕措施的使用率,降低意外妊娠的发生率.

Objective To find out the requirement and to evaluate the effect of post-abortion counseling and education （PACE） among unmarried abortion adolescents.Methods The subjects of the study were unmarried adolescents from 10 to 24 years of age who wanted induced abortion in the Second Affiliated Hospital of Sun Yat-sen University from December 2007 to April 2008.Totally 122 subjects received the intervention of PACE were considered as intervention group.Meanwhile,67 subjects refused the intervention of PACE were considered as no intervention group.Two groups were both investigated the requirements of PACE before abortion and were followed-up at one year after abortion.Results 97.4% （184/189） of 189 unmarried abortion adolescents were willing to receive PACE,48.1% （91/189） of them hoped to receive PACE when saw the doctor,72.0% （136/189） of them required face-to-face counseling during PACE.During the year after abortion,74% （57/77） cases in intervention group and 24% （10/41） cases in no intervention group took effective contraception （P〈 0.01 ）,while 1% （1/77） of intervention group and 10% （4/41） of no intervention group had unwanted pregnancy.There were significant different for the rate of unwanted pregnancy between two groups （P=0.034）.Conclusion For unmarried abortion adolescents,the intervention of PACE may markedly increase the rate of effective contraception used and decrease the rate of another unwanted pregnancy.