不同地区宫内节育器首诊登记与随访服务的实施效果评价  

Evaluation of the effect on implementation of IUD first diagnosed registration and follow-up service in different areas

作　　者：周健[1] 李瑛[1] 冉桂杰 王京玲 庄俊义 丁明 

机构地区：[1]江苏省计划生育科学技术研究所,南京210036 [2]吉林省卫生和计划生育委员会 [3]江苏省卫生和计划生育委员会 [4]广东省卫生和计划生育委员会 [5]云南省卫生和计划生育委员会

出　　处：《中国计划生育学杂志》2016年第1期18-23,共6页Chinese Journal of Family Planning

基　　金："十一五"国家科技支撑计划(2006BAI15B07);中央财政专项"避孕药具不良反应监测与防治"项目;江苏省科技基础设施建设计划(BM2012062)

摘　　要：目的：评价不同地区宫内节育器（IUD）首诊登记制度与随访服务规范的实施效果。方法：2009年1月1日～3月31日在吉林、江苏、广东和云南4省的10个避孕药具不良反应监测点,对需要放置IUD的育龄妇女按照常规要求进行健康筛查、使用登记和随访。结果：江苏和云南两省监测点放置IUD数量前2位均为TCu220C和元宫型（220型）,两者之和分别占各地区放置IUD总数的69.57%和59.10%,但江苏省使用IUD者副反应/健康问题发生率和IUD终止率均低于云南省（P〈0.05）。广东省使用活性金属环型165的比例高达55.82%,江苏省TCu220C占52.80%,虽然IUD种类差异较大,但两个地区使用IUD者副反应/健康问题发生率和IUD终止率均无差异（P〉0.05）。吉林和广东地区再次放置发生IUD副反应/健康问题风险高于首次放置者,吉林和江苏地区使用目录外IUD发生副反应/健康问题的风险高于目录内;江苏和云南地区放置IUD中妇科筛查有异常的人群发生副反应/健康问题风险略有升高。结论：不同地区存在放置IUD种类相似,但避孕效果不同;或使用IUD种类不同,但避孕效果无差异的问题;部分地区存在再次放置IUD、使用目录外IUD、妇科筛查有异常的人群放置IUD副反应/健康问题风险升高的问题。建议：在新形势下,优化整合妇幼保健和计划生育技术服务资源,有效落实避孕药具首诊登记制度与随访服务规范,重视IUD首诊登记和健康筛查,为妇女提供选择适宜的IUD,加强医学随访,出现副反应及时进行医学检查和处理,提高IUD的避孕效果与使用安全性。加强相关区域基层卫生和计划生育技术服务机构的基础建设,增强服务能力,更好的为群众服务,让群众满意。Objective：To evaluate the effect of implementation of IUDs first diagnosed registration and follow-up service in different areas.Methods：Women of childbearing age who inserted different types IUD（intrauterine device） had accepted health screening and registration of the contraceptives,and were followed up for contraceptives adverse reactions at 10 monitoring settings in Jilin,Jiangsu,Guangdong and Yunnan province.Results：The most widely-used types of the IUD were TCu220 C and Yuangong 220 both in Jiangsu and Yunnan provinces,which proportion of using was 69.57% and 59.10%,respectively.The rates of side effect incidence or termination IUD in Jiangsu was significantly lower than that of Yunnan（P〈0.05）.The proportion of active metal ring 165 IUDs inserted was 55.82%in Guangdong province,and the proportion of TCu220 C insertion was 52.80% in Jiangsu province.Although there were quite different on the IUD types,the side effects and the termination rate of IUD showed no significant difference between Guangdong and Jiangsu provinces（P〈0.05）.The proportion of side effects or health problems among women with IUD inserted again was higher than that of women with IUD first-time inserted in Jilin and Guangdong province.In Jilin and Jiangsu province,the risk of side effect of IUD which not in the Government Procurement Contraceptive Directory was higher than that of IUD in the Directory.In Jiangsu and Yunnan province,the risk of side effects and health problems increased slightly among IUD users whose gynecological screening results were abnormal.Conclusion：The study showed that the types of IUD inserted were similar in different province,but contraceptive effect was different.And although the types of IUD were different,contraceptive effect was similar.The results also indicated that the risk of side effects and health problems increased among women with IUD inserted again,among women using IUDs not in the Directory,and among women of abnormal results after gynecological screening in some provinces.Su

关 键 词：评价 宫内节育器 首诊登记 随访 

分 类 号：R169.4[医药卫生—公共卫生与预防医学]