基层宫内节育器避孕失败的高危因素调查  

Risk factors of IUD failure at the grassroots level

作　　者：李桂 

机构地区：[1]浙江省苍南县妇幼保健院妇产科,325800

出　　处：《中国计划生育学杂志》2014年第1期29-32,共4页Chinese Journal of Family Planning

基　　金：苍南县科技局资助项目[苍科(2012)40号:2012S32]

摘　　要：目的：探讨基层妇女使用宫内节育器（IUD）避孕失败的高危因素，为预防失败提供参考。方法：选取2012年5月～2013年5月本院就诊的放置IUD避孕失败的妇女100例作为观察组，用数字表法随机抽出同期采用IUD避孕正常的妇女100例作为对照组。调查两组妇女的基本情况，然后进行logistic回归分析，总结IUD避孕失败（包括IUD合并妊娠及IUD合并异位妊娠）的高危因素。结果：观察组和对照组在年龄、孕产史、月经情况、是否在哺乳期放置、IUD的类型、IUD位置、放置年限、施术者技术、子宫畸形、宫颈松紧度、既往流产史、是否有IUD下移或脱落史、是否合并其他妇科疾病以及是否规范随访等因素均存在统计学差异（P均〈o．05），经多因素非条件logistic回归分析，年龄、孕产史、月经过多、IUD的类型、IUD位置、放置年限、施术者、子宫畸形、宫颈松紧度、既往流产史、IUD下移或脱落史等因素的0R值分别为4．381、5．872、6．849、3．095、6．528、4．692、2．648、2．797、6．029、1．877和2．766，95％CI值分别为3．563～17．428、5．465～20．593、6．257～25．497、2．184～9．546、6．007～24．270、4．183～18．749、1．755～6．490、1．953～8．589、5．746～22．834、1．269～4．554和1．921～8．294；IUD合并异位妊娠与IUD合并妊娠妇女在IUD类型、放置年限、施术者、合并盆腔炎、合并子宫肌瘤或内膜息肉、月经过多、既往流产史等方面均存在统计学差异（P〈0．05），经多因素非条件logistic回归分析，IUD类型、放置年限、施术者技术、合并盆腔炎、合并子宫肌瘤或内膜息肉、月经过多、既往流产史等因素的OR值分别为5．294、4．158、6．569、8．978、8．015、10．187和6．259，95％CI值分别为5．347～21．865、3．752～14．691、6．104～27．384、9．403～36．036、8．927～32．968、10．953～42．581�Objective： To explore risk factors of intrauterine device （IUD） failure at the grassroots level. Methods： One hundred women experiencing IUD failure in Cangnan Maternity ＆ Child Healthcare Hospital From May 2012 to May 2013 IUD were enrolled in the study group and 100 women with normal IUD use served as the control. Risk factors of IUD failure were evaluated with logistic regression analysis. Results： There were significant differences in age, preg- nancy history, menstruation, the type, position and service time of IUD, the skill of the operator, incidences of uterine malformation and cervical tightness, history of induced abortion and IUD expulsion, the incidence of gynecological diseases as well as whether or not experiencing standardized follow-- up between the study group and the control group （P all 〈0.05）. Multivariate logistic regression analysis demonstrated that odd ratios of age, pregnancy history, menorrhagia, the type, position and service time of IUD, the skill of the operator, incidences of uterine malformation and cervical tightness, history of induced abortion and IUD expulsion were 4.381, 5.872, 6.849, 3.095, 6.528, 4.692,2.648, 2.797, 6.029, 1.877 and 2.766. There were significant differences in the type and service time of IUD, the skill of the operator, incidences of pelvic inflammatory disease, uterine fibroid or endometrial polyps, menorrhagia and history of induced abortion between women with ectopic pregnancy and those with pregnancy （P〈0.05）. Multivariate lo- gistic regression analysis demonstrated that odd ratios of the type and service time of IUD, the skill of the operator, incidences of pelvic inflammatory disease, uterine fibroid or endometrial polyps, menorrhagia and history of induced abortion were 5.294, 4.158, 6.569, 8.978, 8.015, 10.187 and 6.259. Conclusion： Age, history of pregnancy, menorrhagia, the type, position and service time of IUD, the skill of the operator, incidences of uterine malformation and cervical tightness, history of induced abortio

关 键 词：宫内节育器 避孕失败 高危因素 调查 带器妊娠 异位妊娠 不良事件 

分 类 号：R169.41[医药卫生—公共卫生与预防医学]