25岁以下未育女性人工流产后即时落实宫内节育器和短效口服避孕药的临床对照观察

Clinical control observation of the immediate intrauterine device inserted and the combination oral contraception used after abortion in nulliparous women aged 25 years old or younger

目的:观察25岁以下未育女性人工流产后即时放置宫内节育器(IUD)和使用短效复方口服避孕药(COC)的可行性和使用情况。方法:将≤25岁未育早孕自愿要求人工流产的女性作为观察对象,根据其意愿术后放置IUD或使用COC避孕。IUD组148例,COC组204例,随访6个月观察两组的避孕情况。结果:两组均无妊娠发生。IUD组1例因完全脱落而终止使用,终止率为0.7%。COC组术后3月的累积停用率69.1%,6月达92.1%,停用的主要原因是嫌麻烦/不能坚持服药,占31.4%。术后1,3个月的不适主诉率IUD组高于COC组(P<0.010,P<0.001)。结论:≤25岁未育女性人工流产后即时放置IUD或使用COC避孕均可行高效。IUD组6个月续用率高;COC副作用轻,但需加强咨询,提高续用率。

Objective:To observe the feasibility and usage of the immediate intrauterine device(IUD)inserted and the combination oral contraception(COC)used after abortion in nulliparous women aged 25 years old or younger.Methods:The nulliparous women aged 25 years or younger who voluntarily requested an abortion were enrolled in this study.According to their preference,these women were assigned to the IUD group(148 cases)and the COC group(204 cases).The women in both groups were followed up for 6 months to observe the usage of IUD or COC.Results:There were no pregnancies reported in either group.In the IUD group,1(0.7%)case discontinued IUD due to complete expulsion of IUD.The cumulative discontinuation rates of the women in the COC group in 3 months and in 6 months after abortion were 69.1%and 92.1%.The main reasons of the discontinuation of COC used of the women were inconvenience and inability to adhere to the medication regimen,which accounting for approximately 31.4%.The rates of the discomfort reported of the women in the IUD group in 1 and 3 months after abortion were significantly higher than those of the women in the COC group(P<0.01,P<0.001).Conclusion:Immediate insertion of the IUD or the COC used after abortion of the nulliparous women aged 25 years old or younger is feasible and effective.The continuation rate of the women with IUD inserted in 6 months after abortion in higher,but the COC used of the women has mild side effects.So,the counseling for the women should be enhanced to improve their continuation rate of IUD or COC.