1 251例重复人工流产术后落实不同避孕方法的效果评价

目的：评价重复人工流产术后即时落实不同避孕方法的效果。方法：1 251例重复人工流产者接受流产后服务（PAC），自愿选择并即时落实避孕方法，随访不同避孕方法的使用情况及不良反应等。结果：所有重复流产者接受PAC后均即时落实避孕措施，其中复方口服避孕药（COC）组随访12个月续用率达31.2%；宫内节育系统（IUS）组随访12个月有3例因有生育要求取出，其余均坚持使用，另外有19例、13例和17例分别于随访3、6、12个月自COC组转入；宫内节育器（IUD）组随访12个月有1例异位妊娠，6例因有生育要求取出，其余均坚持使用，另外有23例、31例和19例分别于随访3、6、12个月自COC组转入。随访中发现部分人群有阴道点滴出血、经量减少、经量增多、闭经、节育环下移和腰酸不适等不良反应，给予处理并充分解释后均继续坚持使用。结论：科学有效的PAC能有效避免重复流产，保护女性生殖健康。

Effectiveness of the Contraceptives Used Immediately after Repeated Abortion in 1 251 Cases

Objective：To evaluate the effectiveness of the immediate implementation of contraceptives after repeated abortion. Methods: With informed consent, contraceptives were implemented in 1 251 cases of repeated abortion during or after the post-abortion care (PAC) service. The clinical application and side effects of contraceptives were followed up. Results: All of those women who received the PAC service after repeated abortion adopted the immediate contraceptives on their own. The rate of sustaining usage in the combined oral contraceptives (COC) group was 31.2% after 12 months of follow-up visit. Only three women in the intrauterine system (IUS) group removed the devices after 12 months of follow-up visit due to the fertility requirement. There were 19, 13 and 17 women who changed from COC to IUS after 3, 6 and 12 months of follow-up visit. Analogously, there were 6 women who removed intrauterine device (IUD), and one who had ectopic pregnancy in the IUD group. There were 23, 31 and 19 women who changed from COC to IUD after 3, 6 and 12 months of follow-up visit. During the whole follow-up visit, some adverse reactions, such as irregular vaginal bleeding, amenorrhea, hypomenorrhea, hypermenorrhea, the ring moved-down and waist soreness and discomfort, were effectively treated. Conclusions: Scientific and effective PAC can effectively avoid repeated abortion and protect female reproductive health.