上海市带宫内节育器异位妊娠发生情况调查  

A Survey on Ectopic Pregnancy with IUD in Situ in Shanghai

作　　者：童传良[1] 刘晓瑷[1] 葛蕙苓[1] 康健中[1] 吴愉[1] 曹长生[1] 

机构地区：[1]中国福利会国际和平妇幼保健院上海市计划生育技术指导所,上海200030

出　　处：《国际生殖健康／计划生育杂志》2010年第5期333-335,339,共4页Journal of International Reproductive Health/Family Planning

摘　　要：目的:了解上海市带宫内节育器(IUD)异位妊娠发生的情况以及相关因素特征,为卫生和计划生育部门制定相关的政策提供科学依据。方法:本研究采用普查的方法,对象为上海市所有能处理剖宫产的93家公立医院,于2006年9月—11月间出院诊断为带IUD异位妊娠的所有患者。结果:共调查到带IUD异位妊娠337例;其中沪籍172例(51.0%),非沪籍165例(49.0%);平均(33.1±5.0)岁。其中沪籍对象年龄大于非沪籍对象([34.4±4.8)岁vs(31.7±4.8)岁,P<0.01]。对象所使用的70%为圆形IUD;在体内平均滞留时间为6年,其中沪籍和非沪籍对象分别为8年和4年(P=0.001)。沪籍与非沪籍对象放置IUD时期分布差异无统计学意义(P>0.05)。结论:建议今后在放置IUD的育龄妇女,特别是有剖宫产史的育龄妇女的生殖保健宣教中,加强对放置IUD后发生异位妊娠危险性的认识,大力提倡放置IUD对象在排卵期性生活时要加用避孕套,使带IUD异位妊娠的发生概率降到最低。建议上海市政府能将符合要求的带IUD异位妊娠对象纳入免费服务的范围或给予一定的医疗补助。Objective：To understand the current situation of ectopic pregnancy with intrauterine device （IUD） in situ and their characteristics in Shanghai,with an aim to provide a scientific basis to make strategies for their prevention.Methods：A census survey was carried out for investigating all cases of ectopic pregnancy with IUD in situ,who were diagnosed from September to November 2006 in all ninety-three public hospitals in Shanghai.Results：A total of 337 cases of ectopic pregnancy in situ were investigated;among which 172 cases of Shanghai and nationality （51.0%）,165 cases of non-Shanghai nationality （49.0%）;The mean age was （33.1 ±5.0） years old,of which Shanghai nationality were older than those non-Shanghai nationality（[34.4±4.8）years old vs（31.7±4.8）years old,P0.01].70% of subjects used circular ring IUD,the mean retention time of the IUDs in vivo was 6 years,and the difference of retention time of IUDs between Shanghai nationality and non-Shanghai nationality was statistically significant （8 years vs 4 years respectively,P=0.001）.The difference of ratios between Shanghai nationality and non-Shanghai nationality within the same insertion pattern was not statistically different.Conclusions：In order to minimize the risk level,awareness of ectopic pregnancy with IUD in situ should be emphasized among futile-aged women with IUD insertion,especially for those with cesarean section history and condom use during the ovulatory period is suggested for those women.It is suggested to Shanghai Municipal Government that free of charge services or some amount of subsidy should be provided to ectopic pregnancies with IUD in situ who meet the requirements.

关 键 词：上海 医院 公立 宫内避孕器 妊娠 异位 普查 

分 类 号：R169.42[医药卫生—公共卫生与预防医学] R714.2