医疗网络平台服务对青少年人工流产术后选择长效可逆避孕方法的影响

目的探讨通过医疗网络平台实施健康宣教和流产后关爱(post-abortion care,PAC)服务对青少年人工流产术后选择长效可逆避孕方法(long-acting reversible contraception,LARC)避孕的影响。方法选取2018年7月至2019年6月在四川省妇幼保健院行非意愿妊娠人工流产的年龄≤25岁的青少年,随机分为对照组(实施传统的健康宣教和PAC服务)和观察组(实施医疗网络平台的健康宣教和PAC服务)。观察两组术后随访率、LARC的实施情况以及重复人工流产率。结果观察组术后1月的随访率为97.95%,与对照组(96.92%)相近,差异无统计学意义(P>0.05),但术后3月、6月的随访率分别为93.98%、89.18%,明显高于对照组(90.08%、81.25%),差异有统计学意义(P<0.05)。观察组术后即刻、术后1月时LARC的应用率分别为12.45%、13.76%,与对照组(13.00%、13.49%)比较,差异无统计学意义(P>0.05),但术后3月、6月的应用率明显增高,分别为25.10%、28.67%,明显高于对照组(15.18%、17.26%),差异有统计学意义(P<0.05)。观察组半年内重复人工流产率为0.92%,明显低于对照组(3.97%),差异有统计学意义(P<0.05)。结论实施医疗网络平台服务后术后长期随访率高、重复人工流产率低,且明显提高了术后3月和6月LARC在青少年中的应用率,但目前应用率仍不理想。

The influence of medical network platform service on the choice of LARC after abortion among the adolescents

Objective To explore the influence of health education and post-abortion care( PAC) services through the medical network platform on long-acting reversible contraception( LARC) after induced abortion among adolescents. Methods Adolescents≤ 25 years of age who have unintentional induced abortion in Sichuan Provincial Hospital for Women and Children from July 2018 to June 2019 were randomly assigned to the control group( received traditional health education and PAC services) and the observation group( received health education and PAC services through medical network platform). The postoperative follow-up rate,the utility ratio of LARC and repeat abortion rate of two groups were statistically analyzed. Results The follow-up rate of the observation group at 1 month after abortion was 97. 95 %,which was similar to that of the control group( 96. 92 %),with no significant difference( P >0. 05). However,the follow-up rate at 3 months and 6 months after abortion of the observation group was 93. 98 % and 89. 18 %,significantly higher than that of the control group( 90. 08 %,81. 25 %),the difference was statistically significant( P < 0. 05). The utility ratio of LARC in the observation group were 12. 45 % and 13. 76 % at the immediately and 1 month after abortion,respectively,which showed no significant difference compared with the control group( 13. 00 %,13. 49 %)( P > 0. 05). However,the utility ratio were significantly higher at 3 months and 6 months after abortion( 25. 10 %,28. 67 %),respectively,compared with the control group( 15. 18 %,17. 26 %),the differences were statistically significant( P < 0. 05). The repeated abortion rate in the observation group within half a year was 0. 92 %,which was significantly lower than that in the control group( 3. 97 %),and the difference was statistically significant( P < 0. 05). Conclusion Through the medical network platform service,the long-term follow-up rate is high and the repeated abortion rate is low,and the utility ratio of LARC in adolescents is significantly increased at 3 months and 6 months after abortion,but the application rate is still not ideal.