剖宫产术后使用宫内节育器停用和副反应的影响因素分析

Investigation of IUD use after cesarean section in native women of Shenzhen

目的:调查剖宫产术后妇女使用宫内节育器(IUD)的情况,为提高该人群使用IUD的有效率提供参考依据。方法:采用分层整群随机抽样方法,对2011年3月1日～2012年11月31日深圳市龙岗区剖宫产术后使用IUD避孕的妇女展开调查。通过跟踪随访、问卷调查、妇科检查和超声等相关检查,对所收集资料进行统计分析。结果:问卷经审核合格并纳入研究的调查对象共2600例,调查对象因不良反应停用IUD的有458例(17.6%),主诉有副反应的有925例(35.6%)。年龄20～29岁组术后使用IUD的停用率(χ2=6.448,P<0.05)和副反应率(χ2=20.67,P<0.005)较高,职业为工人或农民的剖宫产人群使用IUD的停用率(χ2=12.09,P<0.005)较高,文化程度较高者使用IUD的副反应率(χ2=7.93,P<0.05)较高。结论:IUD避孕的停用率和副反应发生率与使用者的社会生物学特征有关。应结合剖宫产术后子宫腔的形态大小情况和使用者的社会生物学特征,对不同人群开展有针对性的放置及随访服务。

Objective： To explore the use of the intrauterine device （IUD） in native women after caesarean section and to pro- vide a foundation of improving the efficient use of the IUD. Methods ： A cross - sectional study method was used. A question- naire survey, gynecologic and ultrasonic examination were conducted among native women with an IUD use after caesarean sec- tion in Longgang District. Results： A total of 2600 validate questionnaires were collected and analysed. The discontinuation rate due to adverse reactions was 17.6%. And 35.6% of the women experienced side effects. There were significantly higher discontinuation rate （χ2 = 6. 448, P 〈 0.05 ） and more side effects （χ2 = 20. 67, P 〈 0. 005 ） in women aged 20 - 29 years. And there were significantly higher discontinuation rate （χ2 = 12. 09, P 〈 0. 005 ） in workers and peasants and more side effects （χ2 = 7.93, P 〈 0.05） in women with higher educational level. Conclusion： The discontinuation rate and incidence of side effects are correlated with users＇social biology characteristics for IU use after cesarean section. Specific services should be provided among different people.