四川省3个县农村育龄妇女宫内节育器使用情况调查

目的:了解四川省农村育龄妇女宫内节育器(IUD)使用情况。方法:采用多阶段分层整群抽样的方法,对四川省3个县农村,共2107例于2004年7月1日～2005年6月30日期间放置IUD妇女进行横断面及前瞻随访研究。结果:3个县育龄妇女普遍使用的3种IUD分别是:母体乐375、TCu380A、宫铜,不同地区使用种类不同(P<0.001)。平均续用率为86.9%,75.3%IUD在乡级服务机构放置。IUD使用失败原因前3类依次为脱落、因症取器和下移取器,分别占4.7%、2.8%、2.7%;带器妊娠率为1.0%。logistic单因素分析显示,防止IUD脱落的保护因素是施术者5年内接受培训(OR=0.817,P=0.007)。结论:建议引入以循证医学为基础的临床路径的管理模式,针对各型IUD特点制定相应的标准操作程序作为技术指南,促进服务质量提高。

An investigation of intrauterine devices use in Sichuan Province

Objective: To explore the current status of intrauterine devices (IUDs) use in Sichuan Province. Methods: A multi-phase stratified cluster sampling method was used, and an epidemiological study with a cross-sectional, retrospective and prospective design was conducted in 2107 IUD users of three counties. Results: The top three IUDs used generally were Mutile-IUD, TCu380A IUD and YGCu IUD. There were differences in IUDs types among women in the three counties (P<0.001). The average continuation rate was 86.9%. About 75.3% of IUD insertions were operated by providers of the township level. The top three failure outcomes were extrusion, removal due to medical reasons and downward dislocation, accounting for 4.7%, 2.8%, 2.7%, respectively. One percent of cases suffered pregnancy with device. The training of the operators within 5 years was the protective factor of the extrusion(OR=0.817, P=0.007). Conclusion: Promotion of the clinic pathway system of IUD operation and construction of the standard operating procedure of different types of IUDs could improve its service qualities.