探讨依托孕烯皮下埋植后阴道不规则出血的危险因素Logistic回归研究

Logistic regression analysis of the risk factors for irregular vaginal bleeding after subcutaneous implantation of Etonogestrel

目的应用Logistic回归分析法分析依托孕烯皮下埋植后阴道不规则出血的危险因素。方法选取2017年6月至2018年6月在广州市红十字会医院接收的220例依托孕烯皮下埋植剂避孕的育龄期妇女作为研究对象。根据是否发生阴道不规则出血将其分为出血组和非出血组,应用单因素和多因素Logistic回归分析法明确导致阴道不规则出血的相关因素。结果 220例进行依托孕烯皮下埋植后阴道不规则出血发生率为31.82%。出血组和非出血组文化程度、避孕药服用史、痛经史、孕次、埋植时间及剖宫产史者构成比比较,差异均无统计学意义(P>0.05),与非出血组相比,出血组年龄<25岁、BMI<18.5 kg/m^2、有IUD应用史、流产≥3次者更多,埋植期非哺乳者构成比较高,差异均有统计学意义(P<0.05),且经Logistic回归分析发现均是导致依托孕烯皮下埋植后阴道不规则出血的危险因素(OR=3.673、2.440、2.898、2.683、2.487;P=0.003、0.000、0.000、0.000、0.003)。结论年龄<25岁、BMI<18.5 kg/m^2、有IUD应用史、流产次数≥3次、埋植期非哺乳均是导致依托孕烯皮下埋植后阴道不规则出血的危险因素,临床中应对存在上述危险因素者给予充分重视,合理选择避孕方式。

Objective To analyze the risk factors of irregular vaginal bleeding after subcutaneous implantation of Etonogestrel by logistic regression analysis. Methods The clinical data of 220 women of childbearing age who received subcutaneous implantation of Etonogestrel from June 2017 to June 2018 were retrospectively analyzed. According to whether irregular vaginal bleeding occurred, they were divided into bleeding group and non-bleeding group. Univariate and multivariate logistic regression analysis was used to identify the related factors leading to irregular vaginal bleeding. Results The incidence of irregular vaginal bleeding was 31.82% in 220 cases after subcutaneous implantation of Etonogestrel. There was no significant difference in educational level, history of contraceptive use, history of dysmenorrhea, times of pregnancy, implantation time and history of cesarean section between bleeding group and non-bleeding group(P>0.05). In the bleeding group, patients with age less than 25 years old, BMI less than 18.5 kg/m^2, IUD application history and abortion no less than 3 times were more, and the proportion of non-lactation during implantation was higher than those in the non-bleeding group accordingly(P<0.05), and Logistic regression analysis showed that the above indicators were all risk factors for irregular vaginal bleeding after subcutaneous implantation of Etonogestrel(OR=3.673, 2.440, 2.898, 2.683, 2.487, P=0.003, 0.000, 0.000, 0.000, 0.003). Conclusions Age under 25 years old, BMI less than 18.5 kg/m^2, IUD application history, abortion no less than 3 times and non-lactation during implantation are all risk factors for irregular vaginal bleeding after subcutaneous implantation of pregnene. Therefore, full attention should be paid to the above risk factors and appropriate contraceptive methods should be chosen reasonably in clinical.