国产皮下埋植剂因月经异常停用的影响因素分析

长效单纯孕激素皮下埋植剂上市20多年来,因其高效、安全、方便、长效、可逆等优点,受到广大育龄妇女的欢迎,但单纯孕激素引起的月经紊乱问题成为限制其可接受性的主要因素1]。本文通过5年的随访研究,采用COX多元逐步回归方法分析中国经产妇使用国产皮下埋植剂后因月经异常停用

Risk Factors for Discontinuation of Norplant Implants Due to Menstrual Irregularities

Objective: To analyze the risk factors for the discontinuation of two types of Norplant implants due to menstrual irregularities during 5-year use among Chinese parous women. Methods: A multi-centre randomized controlled clinical trial was undertaken in eight institutes of China. The data from 14,805 women (7,395 cases of Norplant-I, 7,410 cases of Norplant-II) were analyzed by the methods of life-table and COX Stepwise regression procedure. Results: Menstrual irregularities was the primary factor for discontinuation of implants. The cumulative discontinuation rate after five-year using was 17.00 per 100 women in Norplant-I and 15.26 per 100 women in Norplant-II, respectively. Discontinuation risk due to bleeding seemed to be influenced by educational level, occupation, parity, prior contraceptive use, breastfeeding status, body weight and regions where users lived in. Discontinuation risk for amenorrhea was probably influenced by the type of implant, occupation, parity, breastfeeding status and regions where users lived. Conclusion: Comprehensive counseling and effective treatment are key to reduce the impact of menstrual irregularities and improve the acceptability of the implants.