农村妇女使用宫内节育器的效果分析

本文报道上海郊区农村妇女使用不锈钢宫内节育器448例的随访结果。采用寿命表法计算不同随访时间的宫内节育器继续存放率及各种停用率;用时间等级检验法(或称寿命表差别X~2检验法)对一般认为可能引起脱落的因素如置环后月经量、劳动强度、放置时产次以及放置时间等逐个进行分析。结果,继续存放率随放置年数增加而逐年下降,尤以放置后一年内更为显著,直至五年后基本稳定,七年累计继续存放率为30.25%。累计停用率较高的主要原因为脱落和非因症取出,一年累计脱落率为23.5%,二年达31.94%,以后基本稳定。而放置后二年的非因症取出率迅速上升,六年达88.17%,主要原因为一产妇生育间隔期满而要求再生育。放置后月经量增多和放置时为一产妇女的累计脱落率较高,劳动强度和放置时间与脱落率关系不大。本组资料累计因症取出率较低而带器妊娠率较高,是否与宫内节育器的种类、大小有关,有待进一步探讨。

ANALYSIS OF EFFICACY OF IUD APPLIED ON WOMEN IN SUBURBS OF SHANGHAI

IUD of stainless steel ring is a widely used intrauterine device in the countryside atpresent.The main drawbacks are expulsion and pregnancy with device.We followedup a total of 448 cases which used stainless steel ring,in the suburbs of Shanghai from1973 to 1979.The method of life table was taken to calculate the continuation rates forIUD,and the logrank test to analyse one by one the factors that were generally consideredto be instrumental in expulsion of ring,e.g.menstruation output after insertion,labourintensity,number of birth at insertion and the time of insertion,etc.Results:the continuation rates of IUD decreased with increasing years of insertion.It was most obvious within one year.It was stable on the whole in five years.The cu-mulative continuation rates in seven years was 30.25%.The discontinuation rates were com-paratively high,the main reasons being expulsion and removal for non-medical reasons.Thecumulative expulsion rates in the first year were 23.5%,and the second year,up to 31.94%;after that they were basically stable.However,after the second year,the rates of removalfor non-medical reasons increased quickly.It reached 88.17% in the sixth year.The cause of expulsion was found to be related with menorrhagia after insertion or withwomen who had given birth to one child,after elimination of other influences,The cu-mulative expulsion rates were higher and had little to do with labour intensity and time ofinsertion.In the present series,the cumulative rates of removal for medical reasons werecomparatively low,and the rate of pregnancy with device comparatively high.Whetherthis is related with the type of IUD should be clarified by further investigations.