人工流产后关爱服务对在校未婚女大学生生殖健康的影响

目的了解人工流产后关爱(post-abortion care,PAC)对在校未婚女大学生生殖健康的影响,为高校开展生殖健康教育提供科学根据。方法选择2017年7月-2018年6月就诊于浙江省立同德医院接受人工流产手术的486例在校未婚女大学生,于术前及术后6个月分别进行问卷调查。结果既往有人工流产史248例,其中流产次数≥3次的15例;高危人工流产72例,高危因素主要为半年内再次人工流产以及人工流产次数≥3次。问卷调查显示,PAC干预后女大学生对月经及排卵知识、科学避孕的认知、性传播疾病的认知(疾病种类、传播途径、预防措施)、人工流产危害的认知(近期并发症、远期并发症)等知晓率较干预前提高(χ2值分别为21.42,69.65,71.09,52.80,63.25,187.59,356.02,P值均<0.05)。干预前仅53.7%(261/486)女大学生采取中、低效避孕措施,高效避孕措施仅占0.4%(2/486);干预后全部采取避孕措施,其中术后即刻和术后6个月高效避孕措施落实率分别为85.4%(415/486)和68.3%(332/486),较干预前提高(χ2=786.10,P<0.05)。结论对在校女大学生进行PAC教育可提高性与生殖健康相关知识知晓率,提高术后高效避孕措施落实率,减少重复流产发生率。

Evaluation of the post-abortion care services for unmarried female college students' reproductive health effect

Objective To understand the influence of post-abortion care( PAC) on the reproductive health of unmarried female college students,and to provide scientific basis for reproductive health education. Methods A total of 486 unmarried female college students who received artificial abortion voluntarily due to unwanted pregnancy and had complete follow-up data were investigated by questionnaires before and six months after the operation from July 2017 to June 2018 in the Tongde hospital of Zhejiang Province. Results There were 248 patients with abortion history, including 15 patients with abortion frequency ≥3 times.72 cases of high-risk abortion, the high-risk factors were re-abortion within half a year and the number of abortion ≥3 times;After PAC intervention, the awareness rate on menstruation and ovulation knowledge, scientific contraceptive knowledge, prevention of sexually transmitted diseases knowledge( types of diseases,raltes of transmission and preventive measures), and the harm of abortion knowledge( short-term and long-term complications), was higher than before( χ2= 21.42, 69.65, 71.09, 52.80, 63.25, 187.59, 356.02,P<0.05). Before intervention, only 53. 7%( 261/486) of female college students used medium and low efficiency contraceptive measures, only 0.4%( 2/486) were high-efficiency contraceptive measures. After intervention, all of them used contraceptive measures, The rate of effective contraceptive measures in the immediate and six months after operation was 85. 4%( 415/486) and68.3%( 332/486) respectively, which was significantly higher than before( χ2= 786.10, P< 0.05). Conclusion PAC service for female college students can improve awareness rate of sexual and reproductive health, enhance effective contraceptive measures, reduce the risk of repeated abortion.