使用宫内节育器妇女的副反应发生状况分析

目的了解江苏省使用各类宫内节育器（intrauterine device,IUD）妇女的副反应发生状况。方法对江苏省12 036名使用IUD的育龄妇女副反应发生情况进行横断面调查。结果总的副反应发生率为21.02%,其中出血/疼痛（曾出现出血/月经问题、下腹痛和腰背酸痛中任一种副反应者）的发生率为18.29%。用年龄、文化程度和活产次调整后,苏中地区和苏北地区IUD使用者发生出血/月经问题的风险分别是苏南地区的1.44倍（95%CI：1.28～1.62）和2.16倍（95%CI：1.87～2.50）。结论江苏省使用IUD妇女的副反应发生率较高,地区差异明显;其中出血/疼痛的总发生率最高,仍是副反应防治的重点。应严格掌握放置IUD的适应证及禁忌证,选择合适的IUD;推荐选择含吲哚美辛的IUD,加强对多次人工流产妇女的定期随访和监测、及时发现和规范治疗。

Evaluation on the status of side effect among women with intrauterine devices

Objective To investigate the status of side effect among women with intrauterine devices（IUD）.Methods A total of 12 036 reproductive women with IUD were investigated using cross-sectional study.Results The overall side effect rate reached 21.02%,the rate of bleeding and pain was 18.29%.The risks of side effect among IUD users in central and northern Jiangsu were respectively 1.44 times（95% CI：1.28～1.62） and 2.16 times（95% CI：1.87～2.50） higher than southern Jiangsu after the adjustment of age,educational level and parity.Conclusions The prevalence of side effect among women of reproductive-age in Jiangsu province is high and shows significant differences among regions.The rate of bleeding and pain is so high that it should be the focus of prevention and treatment of side effect.The indication and contraindication should be applied to select suitable IUD and IUDs with indomethacin are highly recommended.Regular follow-up and monitoring should be strengthened among women with induced abortion history and normal treatment should be carried out in time.