品管圈在提高PAC项目长效可逆避孕措施立即落实率中的应用

The application of quality control circle in improving the immediate drop rate of PAC long-acting reversible contraceptive

目的:探讨品管圈在提高PAC项目人流后长效可逆避孕措施(long acting reversible contraception,LARC)立即落实率中的应用。方法:采用随机对照研究及根据样本量计算公式,从2023年12月至2024年2月于本院门诊行人工流产的821例病例中随机选取400例为对照组,经过品管圈质量循环改进后,从2024年6月至2024年8月行人工流产的816例病例中随机选取400例为观察组,利用SPSS 19.0统计软件对数据资料进行统计分析,评价改进效果。结果:单因素分析显示观察组和对照组在年龄、文化程度、产次、流产次数、LARC落实禁忌症证方面,差异无统计学意义(P>0.05);LARC立即落实率由19.5%提升至33.5%,差异有统计学意义(P<0.05);两组1、3、6个月的LARC续用率相比,差异均有统计学意义(P<0.05)。Logistic多因素回归分析显示参加品管圈活动(OR=2.262,95%CI=1.542~3.317)、年龄在21~30岁(OR=4.297,95%CI=1.152~16.026)、31~40岁(OR=3.925,95%CI=1.066~14.45)、产次≥2次(OR=1.744,95%CI=1.015~2.996)是LARC落实率的独立影响因素。结论:品管圈可明显提高PAC项目人流后LARC立即落实率和续用率,尤其是年龄在21-40岁和产次≥2次的育龄妇女更易落实,有利于促进PAC项目的推广。

Objective:To discuss the application of quality control cycle in improving immediate LARC after PAC.Methods:Methods:Based on the randomized controlled study and sample size calculation formula,400 cases were randomly selected from 821 cases of induced abortion in our hospital from December 2023 to February 2024 as the control group,and 400 cases were randomly selected from 816 cases of induced abortion from June to August 2024 as the observation group after improvement of quality control circle quality cycle.Spss19.0 statistical software was used to analyze the data and evaluate the improvement effect.Results:Univariate analysis showed that there was no significant difference between the observation group and the control group in age,education level,birth rate,number of abortion and implementation of CONtraindications for LARC(P>0.05).LARC seed drop rate increased from 19.5%to 33.5%,and the difference was statistically significant(P<0.05).There were statistically significant differences in LARC continuation rates at 1,3 and 6 months between the two groups(P<0.05).Logistic multivariate regression analysis showed that participants in quality control circle activities(OR=2.262,95%CI=1.542~3.317),21~30 years old(OR=4.297,95%CI=1.152~16.026),31~40 years old(OR=3.925,95%CI=1.066~14.45)and yield≥2 times(OR=1.744,95%CI=1.015~2.996)were the independent influencing factors of LARC seed setting rate.Conclusion:Quality control circle can significantly improve the LARC immediately drop rate and renewal rate after PAC project abortion,especially for women of childbearing age between 21 and 40 years old and≥2 births,which is conducive to promoting PAC project.