依托孕烯皮下埋植的避孕效果及阴道不规则出血的影响因素分析  

The contraceptive effect of etonogestrel subcutaneous implantation and the influencing factors of irregular vaginal bleeding

作　　者：李晶[1] 华绍芳[1] LI Jing;HUA Shao-fang(The Second Hospital of Tianjin Medical University,Tianjin 300211,China)

机构地区：[1]天津医科大学第二医院,天津300211

出　　处：《中国新药杂志》2022年第3期257-262,共6页Chinese Journal of New Drugs

摘　　要：目的:探究依托孕烯皮下埋植的避孕效果,并对术后阴道不规则出血情况进行影响因素分析。方法:选取2015年7月—2018年1月于我院门诊有避孕要求的育龄期女性357例,依据就诊顺序随机分为A组(采用依托孕烯皮下埋植避孕,180例)与B组(采用节育器避孕,177例),统计妊娠率,比较两组避孕效果以及不良反应发生情况。并针对A组阴道不规则出血情况,应用多因素Logistic回归分析法分析A组阴道不规则出血情况的危险因素。结果:相较于B组,A组避孕有效率(99.44%vs 92.09%)明显更高,两组比较差异具有统计学意义(P<0.05)。阴道不规则出血情况两组比较无显著差异(P>0.05);相较于B组,A组白带增多、非经期疼痛明显更少,痛经缓解率明显更高,差异均具有统计学意义(P<0.05)。多因素Logistic回归显示:年龄<25岁、BMI<18.5 kg·m^(-2)、有IUD应用史、流产次数≥3次、埋植时处于非哺乳期为依托孕烯皮下埋植后阴道不规则出血的独立危险因素(P<0.05)。结论:相较于宫内节育器,依托孕烯单根皮下埋植避孕效果更理想,可明显减少不良反应,缓解痛经,但易出现阴道不规则出血;年龄<25岁、BMI<18.5 kg·m^(-2)、有IUD应用史、流产次数≥3次、埋植时处于非哺乳期为不规则出血的危险因素,临床应给予足够重视,灵活调整以降低阴道不规则出血发生率。Objective:To explore the contraceptive effect of etonogestrel subcutaneous implantation,and to analyze the influencing factors of irregular vaginal bleeding after surgery.Methods:A total of 357 women of childbearing age,who required contraception in our hospital from July 2015 to January 2018,were randomly divided into group A(using etonogestrel subcutaneous implantation for contraception,180 cases)and group B(Contraception using IUD,177 cases).Pregnancy rate was statistically analyzed,and contraceptive effects and adverse reactions were compared between the two groups.Focusing on the irregular vaginal bleeding in group A,multivariate logistic regression analysis was used to analyze the risk factors of irregular vaginal bleeding in group A.Results:Compared with group B,the effective rate of contraception in group A was significantly higher(99.44%vs 92.09%),and the difference was statistically significant(P<0.05).There was no significant difference in occurrence of irregular vaginal bleeding between the two groups(P>0.05).Compared with group B,group A had more vaginal discharge,significantly less non-menstrual pain,and significantly higher relief rate of dysmenorrhea,and the differences were statistically significant(P<0.05).Multivariate logistic regression showed that:age<25 years,BMI<18.5 kg·m^(-2),history of IUD application,number of miscarriage≥3 times,non-lactating period at the time of implantation,independent of irregular vaginal bleeding after etonogestrel subcutaneous implantation risk factors(P<0.05).Conclusion:Compared with the intrauterine contraceptive device,etonogestrel single root implantation is more effective for contraception.It can significantly reduce adverse reactions and relieve dysmenorrhea,but it is prone to irregular vaginal bleeding;age<25 years old,BMI<18.5 kg·m^(-2),a history of IUD application,the number of abortions≥3 times,and the non-lactating period at the time of implantation are the risk factors for irregular bleeding.Adequate clinical attention should be paid to flexible

关 键 词：依托孕烯 皮下埋植 避孕 阴道不规则出血 影响因素 

分 类 号：R969.4[医药卫生—药理学]