宫内节育器放置技术对使用效果的影响

本文以前瞻性研究方法收集北京市城乡两医院随机放置三种宫内节育器(上海165,北京金塑钢和TCu220C)随访一年的资料,分析结果显示两医院三种宫内节育器第12个月末净累积续用率分别为93.33/每百妇女和99.33/每百妇女,两院节育器使用效果有明显差别(X~2=12.22 P<0.01)。对终止率的影响因素依次为宫内节育器种类,使用妇女的末产结局和放置者的技术水平。TCu220C明显地影响终止率(OR=5.2),末产结局为人流术后的妇女终止的危险是正常分娩后妇女的3.2倍(95％CI1.31～8.0),放置者技术水平的提高对宫内节育器的终止呈现保护作用(OR=2.5)。

Effect of Technical Skill of IUD Insertion on the Efficacy of IUD

The present study analysed the data collected from two clinics located in suburb and county areas of Beijing from July 1989 to September 1991. Total 300 women were recruited separately in each clinic and randomly inserted one of three IUDs (Shanghai 165,Beijing copper-plastic ring and TCu220C)which were carried in real life situation (routine work). The results showed that the net cumulative continuation rate in the two clinics at the end of 12th month after insertion were 93. 33 and 99. 33/100 women which were significant different statistically (x = 12. 22,P>0. 001). The factors effecting cumulative discontinuation rate were types of IUDs,outcome of the last pregnency and the technical skill of operating doctor and nurse. TCu220C markly affect-eel the cumulative discontinuation rate. In postabor-tal IUD insertion. The risk of discontinuation was 3 times that in women after normal birth. Improving the technical skill of operating doctor and nurse tended to have protective effect on the cumulative discontinuation rate(OR=2. 5).