妇科节育手术后感染发生率及其流行趋势探讨

Incidence of the infection after the contraceptive operation and its epidemiological trend

目的:了解目前我国妇科节育手术后感染发生率和流行趋势。方法:利用2007-2020年我国卫生统计年鉴监测的大数据资料,计算放(取)宫内节育器(IUD)、输卵管绝育术、人工流产等节育手术后感染发生率。采用Joinpoint回归模型,计算年度变化百分比(APC)和平均年度变化百分比(AAPC)估计值,对感染率进行趋势分析。结果:从2018-2020年年鉴公布数据来看,目前我国人工流产、输卵管结扎及放(取)IUD手术后感染率分别约为7.3/10万、5.6/10万和5.6/10万,3种手术总体感染率为6.6/10万。从2007-2020年,我国妇科节育手术后总体感染率、放(取)IUD手术后感染率和人工流产手术后感染率均呈不断降低的趋势,AAPC分别为-10.9%、-9.9%和-7.2%(P均<0.05)。总体上2007-2020年输卵管结扎术后感染率呈下降趋势(AAPC=-14.4,P<0.05),但这种下降趋势仅在2007-2012年有统计学意义(APC=-9.5,P<0.05)。结论:我国在妇科节育手术后感染防控方面取得显著成效,妇科节育手术后感染率较低,但节育手术后感染率随访、监测工作依然困难,值得进一步关注与研究。

Objective:To investigate the current incidence of the infection after the contraceptive operation and its epidemiological trend,and to call on the medical and health industry to pay enough attention to the problem of the infection after the contraceptive operation.Methocus:The incidence of the infection after the contraceptive operation was calculated using the data from China's Health Statistics Yearbook monitored between 2007 and 2020,which including the insertion and removal of intrauterine devices(IUD),the tubal sterilization,and the abortion.The estimated values of the annual percent change(APC) and the average annual percentage change(AAPC) were counted by Joinpoin regression model,and the trend analyses of the infection rates after the contraceptive operations were analyzed.Results:According to the data from China's Health Statistics Yearbook monitored between 2018 and 2020,the current infection rates of the patients after abortion,tubal ligation and IUD inserted(removal) in China were approximately 7.3/100,000,5.6/100,000 and 5.6/100,000,respectively,and the overall infection rate of the patients after abortion,tubal ligation and IUD inserted(removal) was 6.6/100,000.From 2007 to 2020,the overall infection rate after the contraceptive operation,the infection rate after IUD inserted(removal) and the infection rate after abortion of the patients showed a decreasing trend,and the AAPC of which were-10.9%,-9.9% and-7.2%,respectively(all P<0.05).From2007 to 2020,the infection rate of the patients after tubal ligation showed a decreasing trend(AAPC=-14.4,P <0.05),but the decreasing trend of the infection rate of the patients after tubal ligation had statistical significance from2007 to 2012(APC=-9.5,P<0.05).Conclusion:The prevention and control of the infections after the contraceptive operation in China has made the remarkable achievements,and the infection rate after the contraceptive operation is low,but the follow-up and the monitoring work after the contraceptive operation is still difficult,and which should be further paid attention to and be researched.