803例城乡育龄妇女宫内节育器不良反应及影响因素分析

目的:探讨IUD不良反应的主要危险因素和降低风险的主要措施,为降低IUD不良反应发生率提供依据。方法:应用IUD的育龄妇女803例采用结构式问卷进行访谈并行妇科临床及B超检查,记录IUD不良反应及可能影响因素。以是否发生不良反应Y作因变量,X1～X22作自变量进行Logistic回归分析。结果:IUD不良反应发生率为24.03%,其中下腹痛2.12%、下坠2.24%、腰酸腰痛3.11%、月经增多4.61%、经期延长5.73%、不规则阴道出血3.49%、白带增多2.74%;Lo-gistic回归分析,痛经、剖宫产史、上取环次数、带环时间、置环后用药及环上缘至宫底浆膜距离6个因素具有统计学关联(P<0.05)。痛经、上取环次数、环上缘至宫底浆膜距离为危险因素,带环时间越短不良反应发生越重,置环后合理用药为保护性因素。结论:治疗痛经、减少宫腔操作、置器后合理用药并定期复诊观察可以有效减少不良反应的发生。

Analysis on adverse reactions and influencing factors of intrauterine device in urban and rural women of childbearing age

Objective:To explore the main risk factors of adverse reactions of intrauterine device(IUD) and the main measures to reduce the risk,and provide a basis for reducing the incidence rate of adverse reactions of IUD.Methods:A total of 803 women of childbearing age with IUD received interview via a structural questionnaire;clinical gynecological examination and ultrasonography were performed,the adverse reactions of IUD and the probable influencing factors were recorded.Y(whether an adverse reaction occurred) was designed as the dependent variable and X1-X22 were designed as independent variables,and then logistic regression analysis was conducted.Results:The incidence rate of adverse reactions of IUD was 24.03%,including lower abdominal pain(2.12%),downward dislocation(2.24%),soreness of waist and lumbago(3.11%),menorrhagia(4.61%),menostaxis(5.73%),abnormal vaginal bleeding(3.49%),and leukorrhagia(2.74%).The results of logistic regression analysis showed that dysmenorrhea,history of cesarean section,times of IUD usage,duration time of IUD usage,drug use after inserting IUD,and the distance between superior border of IUD and outer edge of fundus of uterus were related factors of adverse reactions of IUD(P<0.05).Dysmenorrhea,times of IUD usage,and the distance between superior border of IUD and outer edge of fundus of uterus were risk factors;the shorter the duration time of IUD usage was,the severer the adverse reactions were,reasonable drug use after inserting IUD was one of the protective factors.Conclusion:Curing dysmenorrhea,reducing uterine cavity operation,reasonable drug use after inserting IUD,and regular reexamination and observation can reduce the occurrence of adverse reactions.