未婚女性人工流产术后避孕方式及避孕行为调查

Investigation of contraceptive methods and contraceptive behavior of unmarried women after induced abortion

目的:探讨未婚女性人工流产术后的避孕方式及避孕行为。方法:选择2020年1月—2020年12月在本院行人工流产的未婚女性188例,通过发放调查问卷和随访,了解避孕知识及态度以及流产术后避孕状况。结果:被调查者避孕知识,2.1%认为非常了解,29.8%不太了解;71.8%主要通过互联网了解,对避孕套避孕的知晓率最高(100.0%),对其他避孕方式的知晓率均<50.0%,其中皮下埋植避孕剂和避孕针的知晓率仅为4.8%和2.7%;97.9%认为有必要了解避孕知识,88.8%愿意主动采取避孕措施,75.0%认为流产术会对自己今后婚恋交往产生影响。避孕知识态度的最低得分(51.6±7.7)分(12.0-75.0分)。术后1周,高效避孕措施使用率为89.9%,其中口服避孕药(COC)147例、长效可逆避孕方法(LARC)20例、长效避孕针2例;术后第1个月,高效避孕措施使用率降至58.0%;术后第3个月,高效避孕措施使用率降至37.6%,非高效避孕措施使用率提高到52.7%;术后第6个月,未避孕率提高到15.5%;术后第12个月,高效避孕措施使用率降至29.7%,未避孕率提高到22.5%,意外妊娠率为8.1%。末次随访显示,续用率COC为25.2%,LARC为75.0%。生存曲线分析显示,非高效避孕措施的使用率高于高效避孕措施(P<0.05)。未续用COC的主要原因为“难以坚持每日定时服药”,其次为“药物不良反应”;弃用LARC的主要原因为“不良反应”。结论:行人工流产术的未婚女性避孕知识水平偏低,但术后避孕态度积极,术后经过PAC多数会采取高效避孕方式但不能坚持使用,高效避孕方式的续用率较低,提示临床应加强术前咨询服务工作。

Objective:To investigate the contraceptive methods and contraceptive behavior of unmarried women after induced abortion.Methods:A total of 188 unmarried women who had undergone induced abortion were selected as the respondents.Through questionnaires and follow-up,the contraceptive knowledge and attitude,as well as the contraceptive status of these respondents were investigated.Results:2.1%respondents knew a lot of contraceptive knowledge,and 29.8%respondents knew a little of contraceptive knowledge.71.8%respondents knew the contraceptive knowledge from internet.The awareness rate of condom of the respondents was the highest(100.0%),while the awareness rates of other contraceptive methods of the respondents were all less than 50.0%,especially the awareness rates of implantation contraceptive and contraceptive injection of the respondents were only 4.8%and 2.7%,respectively.97.9%respondents thought it was necessary to know about contraception,88.8%respondents were willing to contraception used on their own initiative,and 75.0%respondents thought that the abortion would have an adverse impact on their future love and marriage.The score of contraceptive knowledge attitude of the respondents was 51.6±7.7 points(the range 12.0-75.0 points),which was the lowest.One week after abortion,the utilization rate of high effective contraceptive of the respondents was 89.9%,which included 147 cases with combination oral contraceptive(COC)used,20 cases with long-acting reversible contraceptive(LARC)used,and 2 cases with long-acting contraceptive injection used.In the first month after abortion,the utilization rate of high effective contraceptive of the respondents decreased to 58.0%.In the third month after abortion,the utilization rate of high effective contraceptive of the respondents decreased to 37.6%,but the utilization rate of non-effective contraceptive of the respondents increased to 52.7%.In the6 th month after abortion,the un-contraceptive rate of the respondents increased to 15.5%.In the 12 th month after abortion,the utilization rate of high effective contraceptive of the respondents decreased to 29.7%,but the utilization rate of non-effective contraceptive of the respondents increased to 22.5%,and the rate of unintended pregnancy of the respondents was 8.11%.In the last follow-up,the continuation rates of COC and LARC of the respondents were25.2%and 75.0%,respectively.Survival curve analysis showed that the usage rate of the non-high effective contraceptive of the respondents was significantly higher than that of the high effective contraceptive of the respondents(P<0.05).The main reason for not continual COC used of the respondents was"difficult to adhere to daily timed medication",and that of followed by"adverse reaction of drug".The main reason for abandoning LARC used of the respondents was"adverse reactions".Conclusion:Unmarried women who underwent induced abortion have a low level of contraceptive knowledge,but their postoperative contraceptive attitude is positive.Most of these women will adopt highefficient contraceptive methods after PAC,but most of them cannot persist in using the high-efficient contraceptive methods with low continuation rate,so it is suggested that preoperative consultation service for the unmarried women should be strengthened.