1450例人工流产女性实施流产后服务的随访研究

Analysis and Following-up Study of 1 450 Cases of Women Who Received Post-Abortion Care

目的:对流产后服务(post-abortion care,PAC)进行临床实践和评价。方法:1 450例因非意愿妊娠在计划生育门诊自愿进行人工流产者,在流产后接受相关的流产后服务,比较患者流产前的一般情况、接受流产后服务用的避孕方案及其相应副作用、坚持避孕方案的时间、重复人工流产的发生率及间隔时间等。结果:所有接受PAC的患者术后均立即采用了避孕措施,术后首月主要采用的避孕方式为口服避孕药(n=573)、屏障避孕(n=551)、曼月乐(n=287)及普通IUD(元宫药铜IUD、活性γ型IUD、TCu220IUD、吉妮致美IUD等)(n=39)。随访12个月后曼月乐组100%坚持使用,普通IUD组使用人数则由最初的39例增至83例,比流产术后增加了1倍以上,主要由原口服避孕药组转入。口服避孕药组的坚持使用率为46.4%。所有坚持随访的女性均未发生随访期间意外妊娠。坚持避孕的各组中,起始有痛经、点滴阴道出血、漏服、环位置下移等不适,均遵医嘱来院处理;随访3个月后各组的不适症状均明显缓解;随访6个月后各组均无不适主诉。结论:科学系统的优质PAC能有效防范重复流产发生,保证避孕效率,从而保护女性的生殖健康。

Objective： To evaluate the effect of post-abortion care in abortion women. Methods： The subjects of the study were 1 450 cases of women who wanted induced abortion and received post-abortion care. They were investigated the general conditions before abortion and were followed up after abortion to gather information about their selection of contraceptive use, side effects, the rate and the time interval of repeated abortion. Results： The women who received post-abortion care mostly used combination oral contraceptives （COC, n=573）, condom （n=551）, Mirena （LNG-IUS, n=287） or normal IUD （n=39）. During the year after abortion, 100% cases in Mirena （LNG-IUS） group, and 46.4% cases in COC group didn＇t change their contraceptive choice. And the cases in normal IUD group increased 44 cases after one year （n=83）. No unwanted pregnancy occurred in all the women except follow-up were lost in some cases. In the beginning, all the women who have menorrhalgia, colporrhagia, missed dose, displacement of IUD and other discomforts, came to hospital for treatment. The discomforts were obviously alleviated after 3 months, and disappeared after 6 months. Conclusion： Post-abortion care may markedly increase the rate of effective contraception used, decrease the rate of unwanted pregnancy, and be beneficial to the reproductive health of women.