年轻未育女性人工流产术后长效可逆避孕方式的选择分析  

Acceptability of the long acting reversible contraception in nulliparous after induced abortion

作　　者：周颖 乌守恒 郑伟[1] 曾晓峰[1] 王萍[1] 苏留莉 林卫[1] ZHOU Ying;WU Shou-heng;ZHENG Wei;ZENG Xiao-feng;WANG Ping;SU Liu-li;LIN Wei(West China Second University Hospital,Sichuan University,Chengdu 610041)

机构地区：[1]四川大学华西第二医院出生缺陷相关妇儿疾病教育部重点实验室

出　　处：《生殖医学杂志》2019年第12期1458-1462,共5页Journal of Reproductive Medicine

基　　金：成都市科技局软科学项目(2016-RK0000198-ZF)

摘　　要：目的观察年轻未育女性人工流产术后避孕方法的选择,分析长效可逆避孕方式(LARC)的使用情况及影响因素。方法收集我院2016年6月至2017年3月实施人工流产术的309例年轻未育女性为研究对象,回顾性分析其临床资料,随访观察研究对象行人工流产术后第1、3、6、12个月避孕方法的使用情况并分析其未使用LARC的原因。结果309例研究对象中,选择高效避孕方式者由术前的2.9%[复方短效口服避孕药(COC)]明显提高到术后的88.0%(COC和LARC),术后264例研究对象选择COC,占85.4%;8例研究对象选择LARC,仅占2.6%。研究对象未选用LARC的原因依次为:担心LARC影响生育力(39.5%)、担心LARC相关并发症(23.3%)、担心宫腔手术操作风险(17.8%)、PAC人员未予以详尽解释(7.1%)、认为LARC价格昂贵(4.9%)、父母或家属不同意使用(4.2%)、其他原因(3.2%)。术后随访第1、3、6、12个月,COC的续用率显著下降,而LARC的续用率则相对稳定;随访至第6个月时,使用COC者再次非意愿妊娠的发生率为2.8%(7/251),明显高于LARC使用者的0.0%。结论虽然LARC的续用率和有效性均优于COC,但年轻未育女性人工流产术后LARC的落实率仍极低,这与年轻未育女性对LARC存在错误认知及计划生育服务提供者的解释不充分有关。Objective:To observe the choice of contraceptive methods after induced abortion in young nulliparous women,and to analyze the use and influencing factors of long acting reversible contraception(LARC).Methods:309 young nulliparous women who underwent induced abortion from June 2016 to March 2017 were enrolled in the study.The clinical data were retrospectively analyzed.The choice of contraceptive methods and the reasons for not using LARC were followed up in the 1st,3rd,6th and 12th month after induced abortion.Results:The choice of high-efficiency contraception increased from preoperative 2.9%(COC)to postoperative 88.0%(COC and LARC),and 264 women(85.4%)selected COC after induced abortion,and only 8 women(2.6%)selected LARC.The reasons for the absence of LARC were:worry about the effect of LARC on fertility(39.5%),worry about other related complications(23.3%),concern about the risk of operation in uterine(17.8%),the lack of detailed explanations from PAC staff(7.1%),the high price(4.9%),due to the disagreements of parents or partner(4.2%)and other causes(3.2%).The continuation rate of COC declined rapidly than LARC after induced abortion and the repeated unintended pregnancy rate of COC(2.8%)was higher than LARC(0.0%).Conclusions:Although the continuation rate and effectiveness of LARC are better than COC,the acceptability of LARC in nulliparous women was very low.This is related to the inadequate interpretation of LARC and the inadequate explanation from family planning service provider.

关 键 词：人工流产 长效可逆避孕方式 年轻未生育女性 

分 类 号：R169.41[医药卫生—公共卫生与预防医学]