慢性肾脏病育龄期女性患者避孕现状及影响因素

Contraceptive situation and influencing factors of women in childbearing age with chronic kidney disease

目的了解慢性肾脏病(CKD)育龄期女性患者避孕现状及影响因素,为提高其生殖健康水平提供依据。方法对东部战区总医院国家肾脏疾病临床医学研究中心2018年11月至2019年2月期间256例CKD育龄期女性患者进行现况调查,对调查结果进行统计分析。结果共调查256例,回收有效问卷246份。其中,36.18%未采用避孕措施,53.25%采用1种避孕措施,10.57%采取2种或以上的避孕措施。避孕措施使用比例依次为避孕套51.59%、宫内节育器45.86%、口服药物7.01%、安全期7.01%、体外射精5.10%、避孕针剂0.64%。3.25%明确使用仅含孕酮的避孕制剂,包括宫内节育器及口服药物。单因素分析显示,不同年龄、婚姻状态、是否为独生子女、生育情况、伴侣对避孕的态度、是否接受避孕指导、是否存在水肿、意愿生育数目与是否采用避孕措施有关,差异均有统计学意义(P<0.05)。多因素分析显示,已婚、现有2个及以上子女数量、接受避孕指导、伴侣对避孕态度积极者更多的采取避孕措施(P<0.05)。结论CKD育龄期女性患者避孕措施尤其有效避孕措施使用率较低,易发生意外妊娠。应加强相应患者避孕咨询,提高其有效避孕措施的使用。

Objective To investigate the contraceptive status and influencing factors of women at reproductive age of chronic kidney disease(CKD),so as to provide evidence for improving reproductive health of women with CKD.Methods A total of 256 female patients of reproductive age of CKD from November 2017 to February 2019 at National Clinical Research Center of Kidney Diseases,Jinling Hospital were selected to investigate the contraceptive status.And the investigation results were analyzed.Results A total of 256 patients were investigated,and 246 valid question-naires were collected.Eighty-nine(36.18%)patients did not use contraceptive methods,131(53.25%)patients used one contraceptive method,and 26(10.57%)patients used two or more contraceptive methods.The proportion of contraceptive users in order were condoms 51.59%,intrauterine devices 45.86%,oral drugs 7.01%,safe period 7.01%,external ejaculation 5.10%,and contraceptive injection 0.64%.Univariate analysis showed that age,marital status,one-child status,birth status,partner's attitude towards contraception,whether to accept contraceptive guidance,whether to have edema,and the number of children they intended to have were all related to the use of contraceptive measures,with statistically significant differences(P<0.05).Multivariate regression analysis showed that those who were married,had 2 or more children,received contraceptive guidance,and had a positive attitude towards contraception were more likely to take contraceptive measures(P<0.05).Conclusion Child-bearing age women with CKD have a lower rate of contracep-tive use,especially long-duration contraception,and a higher risk of unintended pregnancy.Nurses should strengthen the propaganda and education of contraceptive knowledge of CKD patients,and take targeted intervention measures to improve the utilization rate of contraceptive tools.