高危人群人工流产后立即高效避孕的临床观察

Clinical observation of high effective contraception immediately after induced abortion in high risk population

目的探讨高危人群人工流产术后立即放置宫内节育器(intrauterine device,IUD)或口服复方短效避孕药,对人工流产后出血、感染、月经恢复、宫腔粘连以及再次意外妊娠的影响。方法将要求终止早孕的重复(≥3次)或高危人工流产者400例分为两组,每组200例。观察组人工流产术后立即放置圆形含铜含吲哚美辛IUD,对照组人工流产术后立即口服屈螺酮炔雌醇片避孕。结果两组术后出血量、出血时间、术后感染情况比较差异无统计学意义(P>0.05),而两组术后月经恢复,闭经、痛经、宫腔粘连,术后12个月内意外妊娠的发生情况比较差异有统计学意义(P<0.05)。结论高危人群人工流产后立即采取高效避孕措施是安全、可靠、有效的。IUD在高效避孕的同时还有助于术后月经恢复,减少闭经痛经发生,预防宫腔粘连,降低术后12个月内再次意外妊娠的发生。对于短期无生育要求(指2年内无生育计划)者,建议人工流产术后立即放置IUD。

Objective To investigate the effect of immediate contraceptive use of intrauterine device or oral compound short - acting contraceptive pill on bleeding, infection, menstrual recovery, intrauterine adhesions, and unplanned pregnancy after high - risk induced abortion. Methods 400 cases required termination of early pregnancy repeat （ I〉 3 times） or high - risk abortion were divided into two groups randomly. Round copper containing indometaein intrauterine device was inserted immediately after abortion in the study group. And the control group was administrated drospirenone orally immediately after induced abortion. Results There were no significant differences in bleeding volume, bleeding time and postoperative infection between the two groups （ P 〉 0. 05 ） , but there were significant differences in menstrual recovery, amenorrhea, dysmenorrhea, intrauterine adhesions and the incidence of unplanned pregnancy within 12 months after operation （P 〈 0. 05）. Conclusion Immediate use of contraceptive methods after abortion for high - risk population is safe, reliable and effective contraceptive methods. For people with short - term non - fertility requirements（ 2 years without childbirth plan） , abortion immediately after the placement of IUD is suggested. It is efficient in contraception, helps menstrual recovery post surgery, reduces the occurrence of amenorrhea dysmenorrhea, prevents intrauterine adhesions and reduces the occurrence of unwanted pregnancies 12 months postoperative.