2956例人工流产女性现状分析及人工流产后关爱服务在生殖健康中的作用评价

Analysis of Current Status of Artificial Abortion of 2956 Cases and the Evaluation of the Effect of Post-abortion Care in Female Reproductive Health

目的调查人工流产现状,评价人工流产后关爱服务在女性生殖健康中的作用。方法调查2014年度郑州大学第二附属医院妇科门诊行人工流产的女性共2 956例,调查患者的年龄、婚姻状况、人工流产次数及本次非意愿妊娠原因等,调查患者对避孕相关知识需求程度,建立标准化人工流产后关爱服务模式,开启"关爱至伊,流产后关爱(PAC)"项目。调查患者人工流产后1、3、6个月高效避孕措施落实情况;对人工流产和避孕相关知识设计10个问题,调查患者人工流产前及人工流产后1、3、6个月答题正确情况。结果 2 956例人工流产患者,初次人工流产1 498例(50.68%),两次及两次以上人工流产1 458例(49.32%),人工流产次数最多者13次。本次非意愿妊娠原因:未采取避孕措施1 512例(51.15%),避孕失败1 444例(48.85%),其中避孕套失败481例,紧急避孕药失败248例,宫内节育器失败10例,安全期及体外排精等其他避孕措施失败705例。2 956例人工流产患者中,非常渴望得到避孕相关知识1 604例(54.26%),一般935例(31.63%),持无所谓态度417例(14.11%)。人工流产后1、3、6个月短效口服避孕药使用人数分别为:1 597例(63.27%,1 597/2 524)、869例(43.60%,869/1 993)、138例(10.08%,138/1 369),人工流产后1、3、6个月已婚者宫内节育器放置人数分别为:236例(9.35%,236/2 524)、312例(15.65%,312/1 993)、299例(21.84%,299/1 369)。人工流产前及人工流产后1、3、6个月答题正确情况比较,差异有统计学意义(P<0.01)。结论目前我国人工流产率及重复人工流产率均较高,人工流产后关爱服务在女性生殖健康中有一定作用,能促使高效避孕方法的使用,并能增加女性对人工流产及避孕相关知识的了解。

Objective To investigate the current status of artificial abortion,and to evaluate the effect of post -abortion care in women＆#39;s reproductive health. Methods 2 956 cases who had artificial abortion in the Department of Gynecology Outpatient of the Second Affiliated Hospital of Zhengzhou University in 2014,were selected as study subjects. The age,marital status,frequency of artificial abortion,reasons for unwanted pregnancy,and the degree of patients＆#39; demand for contraceptive knowledge were investigated,the standardized post - abortion care service model was established,thus the post - abortion care project was implemented. The situation of effective contraceptive measures 1,3,6 months after artificial abortion was investigated. 10 questions were designed to test knowledge about artificial abortion and contraception among cases,and the correct situation of answer before artificial abortion and 1,3,6 months after artificial abortion was investigated. Results Among 2 956 cases who had artificial abortion,1 498 cases（50. 68% ）had artificial abortion for the first time,1 458 cases（49. 32% ）had artificial abortion for two times and more,the maximum frequency of artificial abortion was 13. Reasons for unwanted pregnancy：1 512 cases（51. 15% ）had no contraceptive measures,and 1 444 cases（48. 85% ）had contraceptive failure,among whom 481 had condom failure,248 had emergency contraceptive failure,10 had intrauterine device（ IUD）failure,705 had other contraception measures failure（safety period,coitus interruptus,and so on）. Among 2 956 cases who had artificial abortion,1 604 cases（54. 26% ）were in urgent need of contraceptive knowledge,935 cases（31. 63% ）need contraceptive knowledge moderately,417 cases（14. 11% ）were quite unconcerned about contraceptive knowledge. Number of combined oral contraceptive （COC）taking 1,3,6 months after artificial abortion was 1 597（63. 27% ,1 597 / 2 524）,869（43. 60% ,869 / 1 993）and 138（10. 08% ,138 / 1369）respectively. Number of married cases who placed IUD 1,3,6 months after artificial abortion was 236（9. 35% ,236 / 2 524）,312（15. 65% ,312 / 1 993）and 299（21. 84% ,299 / 1 369）respectively. There was significant difference in correct situation of answer before and after artificial abortion（ P ﹤ 0. 01）. Conclusion At present,the rate of artificial abortion and repeated abortion in China are relatively high,the post - abortion care can benefit the female reproductive health to some extent,which can promote the use of efficient contraception,and can increase the knowledge awareness of artificial abortion and contraception.