中国九省农村育龄妇女宫内节育器下移取器现状流行病学调查

目的 探索育龄妇女宫内节育器(IUD)下移取器的发生现状和影响IUD使用效果的严重程度.方法 运用描述性研究方法,采用分层整群抽样的纵向性研究,对我国农村地区18 922名放置IUD的妇女进行横断面调查和历史前瞻性随访.结果 育龄妇女IUD除完全脱落外,下移取器是造成IUD使用失败的主要原因.与其他IUD使用失败的原因相比,其构成百分比随使用时间延长而升高,由不足1/6上升至1/5.IUD使用失败原因别累计失败率居于前三位的是完全脱落、下移取器和带器妊娠,其累计失败率(每百名妇女)分别为完全脱落:使用1个月为0.33%,3个月为1.13%,6个月为2.21%,12个月为4.30%;下移取器:使用1个月为0.10%,3个月为0.37%,6个月为0.80%,12个月为2.34%;带器妊娠:使用1个月为0.03%,3个月为0.14%,6个月为0.41%,12个月为1.14%.结论 育龄妇女下移取器严重影响着IUD的使用效果,其发生情况不容忽视.

An epidemiologicul survey on intrauterine device downward dislocation in Chinese rural users

Objective To understand the situation of downward dislocation of intrauterine device (IUD) and the impact related to the effectiveness of IUD use, in China. Methods An epidemiological survey with cross-sectional, retrospective and prospective study designs was conducted to investigate 18 922 IUD users who were selected by a multi-phase stratified cluster sampling method. Results IUD's downward dislocation had been an important unsuccessful issue related to the IUD insertion that accounted for 20% of total the cases of failure. The top three failure outcomes would include extrusion,removal due to downward dislocation and unintended pregnancy. Respectively, the cumulative rates and the ranking due to IUD failure (per 100 women) in the first, third, sixth and twelfth month were shown as follows: extrusion appeared as 0.33%, 1.13%, 2.21% and 4.30%; removal as 0.10%, 0.37%, 0.80% and 2.34% ; while unintended pregnancy were 0.03%, 0.14%, 0.41% and 1.14%. Conclusion IUD' s downward dislocation made great impact on the effectiveness of IUD use that should call for attention from relative governmental sectors and researchers in the areas of prevention, diagnosis and treatment.