江苏苏南地区宫内节育器首诊登记及随访情况评价

Evaluation of IUD first-diagnosed registration and follow-up system in south of Jiangsu Province

目的评价江苏苏南地区宫内节育器(intrauterine device,IUD)首诊登记与随访服务的实施效果。方法于2015年9月至2018年12月对江苏省苏南地区宜兴市放置IUD的妇女进行健康筛查、使用登记和随访观察。结果共收到4202例育龄妇女记录,涉及29种IUD。首次放置IUD对象占33.98%,其中高危人群占3.78%,高于再次放置对象(2.60%)(P<0.05)。首次放置对象宫颈异常比例高于再次放置对象(P<0.05)。共有3935例对象在置器1年内接受至少1次随访,IUD不良反应发生率为12.10%,宫铜200 IUD发生风险最高(RR=1.81,95%CI:1.50-2.20);OCu IUD风险最低(RR=0.14,95%CI:0.07-0.27)。有不良反应妇女但未接受妇科检查的比例高达91.39%,未得到医学处理的比例为88.87%。结论IUD首诊登记与随访制度具有重要的公共卫生学意义,需特别关注首次放置人群和高危人群健康情况,加强随访,提高医学检查比例和对症处理能力,从而为育龄妇女选择适宜和可接受的IUD品种,提供更优质服务。

Objective To evaluate the effect of IUD first-diagnosed registration and follow-up system in south of Jiangsu Province.Methods From September 2015 to December 2018,women who inserted IUDs in Yixing City,Jiangsu Province experienced health screening and use registration,and follow-up observation.Results 29 different kinds of IUD were inserted among 4202 women of childbearing age.The proportion of the first-time IUD user was 33.98%,in which high-risk population accounted for 3.78%,which was higher than users placed again(2.60%)(P<0.05).The proportion of cervical abnormalities in the first-time IUD users was higher than that in the users placed again(P<0.05).A total of 3935 users completed at least one follow-up visit within one year,the incidence of IUD adverse effects was 12.10%.The risk of side effect of the medicated GT200 was the highest(RR=1.81,95%CI:1.50-2.20),OCu IUD was the lowest(RR=0.14,95%CI:0.07-0.27).The proportion of women who had adverse reactions but did not undergo gynecological examination was as high as 91.39%,and the proportion without medical treatment was 88.87%.Conclusion IUD first-diagnosed registration system has important public health significance.In order to choose suitable IUDs and provide better service for women of childbearing age,special attention needs to be paid to the health of first-time IUD users and highrisk populations,strengthen follow-up,improve the proportion of medical examinations and the ability of symptomatic treatment.