宫内节育器放置后副反应与异位发生风险的11病例对照研究  

A 1:1 matched case control study on the relationship between the side effects and risk of ectopic intrauterine devices

作　　者：孙志明[1] 王冠融 施雯慧[1] 张学宁[1] 周健[1] 姚捷[1] 杨月华[1] 张敏[1] 

机构地区：[1]江苏省计划生育科学技术研究所,国家卫计委计划生育药具不良反应监测中心,南京210036

出　　处：《中国计划生育学杂志》2016年第6期384-387,共4页Chinese Journal of Family Planning

摘　　要：目的：探索放置宫内节育器（IUD）后副反应与异位发生风险的关系,为规范随访服务和预防IUD异位发生提供科学依据。方法：采用1：1病例对照研究方法,对2013年7月1日~2015年6月30日在国家卫计委计划生育药具不良反应监测中心收集的104例IUD异位病例,并匹配同一地区年龄相差≤3岁同期放置且正在使用IUD、未发生不良事件的104例育龄妇女作为对照,采用条件logistic回归分析和配对卡方检验进行IUD异位风险因素的分析评价。结果：病例组总副反应和疼痛副反应发生比例（28.85%、16.35%）均高于对照组（10.58%、1.92%）（均P〈0.001）;两组出血、分泌物异常和其他副反应发生比例未见统计学差异（均P〉0.05）。条件logistic回归分析显示,放置IUD后出现疼痛副反应增加了IUD异位风险,比值比（OR）为8.50（95%CI：1.96~36.79）,调整后OR为39.93（95%CI：3.10~513.72）。结论：放置IUD后疼痛副反应显著增加了IUD异位风险,建议加强施术医生培训,关注IUD使用对象腰背疼痛等不适主诉度给予及时治疗和处理,加强随访服务以更好预防IUD异位发生。Objective： In order to provide scientific evidence for follow-up service of IUD inserted and for preventing ec- topic IUD, this study was to explore the relationship between the side effects of intrauterine device （IUD） and the risk of eetopic IUD. Method.. A 1：1 matched case control study was conducted. From July 2013 to June 2015, women with ectopic IUD collected by NPFPC Contraceptive Adverse Reaction Surveillance Center were included in the study. And the women who were using IUD in the same area, no any side effects, and age difference less than 3 years were matched as control. Conditional Logistic regression analysis and paired ehi square test were used for analysis and evalu- ation of risk factors of ectopic IUD. Result= The proportion of total side effects and pain of the case group （28.85 G and 16.35 ~//0, respectively） were significantly higher than those of control group （ 10.58 G and 1.92 %, respectively）, P ~0. 001. The proportion of bleeding, abnormal secretion and other side effects of case group were similar as those of con- trol group, P ~ 0.05. Conditional logistic regression analysis showed that the rate of women feeling pain after IUD in- serting would significantly increased risk of ectopic IUD, and odds ratio（OR） was 8.50 （95G CI： 1.96, 36.79）, the adjusted OR was 39.93 （95G CI： 3.10, 513.72）. Conclusion： Pain after IUD insertion will significantly increases risk of ectopic IUD. So it is recommend that IUD inserting training for providers should be strengthened, and providers should be paid more attention to pain or other discomfort of women after IUD inserted. In order to prevent ectopic IUD, women with IUD inserted should be emphasized on follow-up and any pain should be treated timely.

关 键 词：宫内节育器 副反应 异位 风险因素 病例对照研究 疼痛 

分 类 号：R169.41[医药卫生—公共卫生与预防医学]