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中华妇幼临床医学杂志(电子版) ›› 2012, Vol. 08 ›› Issue (04) : 457 -460. doi: 10.3877/cma.j.issn.1673-5250.2012.04.016

所属专题： 专题评论； 文献；

论著

基层医院开展人工妊娠终止术后计划生育服务干预实施效果评价
范江诺1,*,*(), 范江华2, 尚仁香1   
  1. 1. 265100　山东青岛，青岛大学医学院附属医院海阳分院妇产科
    2. 山东省海阳市疾病预防控制中心
  • 收稿日期:2012-03-10 修回日期:2012-07-01 出版日期:2012-08-01
  • 通信作者: 范江诺

Effects of Post-Abortion Family Planning Service in the Primary Hospital

Jiang-nuo FAN1(), Jiang-hua FAN2, Ren-xiang SHANG1   

  1. 1. Department of Obstetrics and Gynecology, Affiliated Haiyang People's Hospital, Qingdao University Medical College, Haiyang 265100, Shandong Province, China
  • Received:2012-03-10 Revised:2012-07-01 Published:2012-08-01
  • Corresponding author: Jiang-nuo FAN
  • About author:
    (Corresponding author: FAN Jiang-nuo, Email: )
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范江诺, 范江华, 尚仁香. 基层医院开展人工妊娠终止术后计划生育服务干预实施效果评价[J]. 中华妇幼临床医学杂志(电子版), 2012, 08(04): 457-460.

Jiang-nuo FAN, Jiang-hua FAN, Ren-xiang SHANG. Effects of Post-Abortion Family Planning Service in the Primary Hospital[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2012, 08(04): 457-460.

目的

探讨基层医院开展人工妊娠终止术后计划生育服务(PAFPS)的实施效果。

方法

随机选择2010年1月至12月在青岛大学医学院附属医院海阳分院妇产科门诊行人工妊娠终止术患者400例为研究对象。采用本研究自行设计的《人工妊娠终止术情况调查》在术前进行初始问卷调查；按就诊顺序将其分为干预组(n＝200)和对照组(n＝200)(本研究遵循的程序符合青岛大学医学院附属医院海分院人体试验委员会制定的伦理学标准，得到该委员会批准，分组征得受试者的知情同意)，对干预组患者术后进行PAFPS，对照组仅提供常规人工妊娠终止术后医疗服务。随访1年后，对所有受试者采用初始问卷再次调查，重点调查避孕节育相关知识知晓情况，避孕措施实施情况及再次非意愿妊娠情况。

结果

随访1年后，收回有效问卷386份，其中干预组为194份，对照组为192份。干预组和对照组的避孕相关知识得分分别为(9.31±1.74)分，(6.11±1.81)分，两组比较，差异有统计学意义(t＝17.70，P<0.01)。干预组采取主动避孕措施者(78.87%)高于对照组(62.50%)，两组比较，差异有统计学意义(χ2＝38.76，P<0.01)。干预组与1年前比较，采取较为可靠的避孕措施[避孕套、避孕药、放置宫内节育器(IUD)]比例更高(74/109，χ2＝12.67，P<0.01)。干预组1年内非意愿妊娠为5.73%(11/192)，对照组为18.75%(36/192)，两组比较，差异有统计学意义(χ2＝24.36，P<0.01)；干预组1年内再次行人工妊娠终止术发生率为2.58%(5/194)，对照组为10.94%(21/192)，两组比较，差异有统计学意义(χ2＝10.74，P<0.01)。

结论

在基层医院开展PAFPS，对育龄妇女避孕节育相关知识的掌握，提高避孕措施使用比例，降低非意愿妊娠和人工妊娠终止术发生率，提高生殖健康水平有一定的效果。

关键词: 人工妊娠终止术, 人工妊娠终止术后计划生育服务, 避孕措施, 非意愿妊娠
Objective

To study the effects of post-abortion family planning service (PAFPS) in the primary hospital.

Methods

From January to December 2010, a total of 400 women who underwent pregnancy termination were recruited in this study. They were randomly divided into PAFPS group (n=200) and control group (n=200) according to the visiting sequence. PAFPS group received PAFPS knowledge, and control group only received routine medical service. All of the women were surveyed by Questionnaire of Pregnancy Termination. The main contents were about awareness of contraceptive knowledge, the occurrence of unwanted pregnancy, and so on. After one-year's follow-up, the same questionnaire survey was conducted again.

Results

A total of 386 (96.5%, 386/400) validated questionnaires were recovered after one-year's follow-up, including 194 (97.0%, 194/200) in PAFPS group and 192 (96.0%, 192/200) in control group. The scores of contraceptive awareness of PAFPS group and control group were (9.31±1.74) score and (6.11±1.81)socre, respectively, with significant difference (t=17.70, P<0.01). The women turned to initiative contraceptive use in the PAFPS group (78.87%) were more than those in control group, which showed significant difference (62.50%, χ2=38.76, P<0.01). And the incidence of unwanted pregnancy in PAFPS group (5.73%) was lower than that in control group (18.75%) (χ2=24.36, P<0.01).

Conclusions

PAFPS is an effective way for reproductive women to improve their awareness of contraceptive knowledge and initiative contraception. Reduce unwanted pregnancy and pregnancy termination rate, resulting in promoting the reproductive health.

Key words: pregnancy termination surgery, post-abortion family planning service, contraceptive measure, unwanted pregnancy
表1 两组一般资料比较[n(%)]
Table 1 Comparison of general information between two groups [n(%)]
组别 年龄(±s，岁) 婚姻状况 文化程度
已婚 未婚 寡居 初中以下 高中(中专) 大专及以上
干预组 24.47±6.21 128 (65.98) 60(30.93) 6(3.09) 27(13.92) 123(63.40) 44(22.68)
对照组 24.56±6.47 125(65.11) 61(31.77) 6(3.13) 30(15.63) 124(64.58) 38(19.79)
χ2/t 0.1394 0.03 0.59
P >0.05 >0.05 >0.05
组别 职业 既往流产次数(次)
干部 职员 农民 工人 其他 0 1 ≥2
干预组 7(3.61) 27(13.92) 52(26.80) 67 (34.54) 41(21.13) 110(56.70) 67(34.54) 17(8.76)
对照组 7(3.65) 26(13.54) 54(28.13) 65(33.85) 40(20.83) 108(56.25) 65(33.85) 19(9.90)
χ2 0.09 0.15
P >0.05 >0.05
组别 避孕方式
主动避孕 避孕套 避孕药物 放置IUD 紧急避孕 安全期 体外排精
干预组 111(57.22) 35(18.04) 31(15.98) 8(4.12) 17(8.76) 8(4.12) 12(6.19)
对照组 109(56.77) 35(18.23) 30(15.63) 8(4.17) 16(8.33) 9(4.69) 11(5.73)
χ2 0.13
P >0.05
表2 两组干预前、后对避孕节育知识得分比较(±s，分)
Table 2 Comparison of contraception knowledge before and after intervention between two groups (±s，score)
组别 n 干预前 干预后
干预组 194 6.14±1.39 9.31±1.74
对照组 192 6.09±1.37 6.11±1.81
t ? 0.36 17.70
P ? >0.05 <0. 01
表3 两组干预前、后避孕措施变化情况[n(%)]
Table 3 Changes of contraceptive measures before and after the intervention between two groups [n(%)]
组别 n 主动避孕 避孕套 避孕药物 放置IUD 紧急避孕 安全期 体外排精
干预组 ? ? ? ? ? ? ? ?
? 干预前 200 111(55.5) 35(17.5) 31(15.5) 8 (4.0) 17(8.5) 8(4.0) 12(6.0)
? 干预后 194 153(78.9) 41(21.1) 39(20.1) 29(14.9) 18(9.3) 14(7.2) 12(6.2)
对照组 ? ? ? ? ? ? ? ?
? 干预前 200 109(54.5) 35(17.5) 30(15.0) 8(4.0) 16(8.0) 9(4.5) 11(5.5)
? 干预后 192 120(62.5) 36(18.8) 33(17.2) 10(5.2) 13(6.8) 14(7.3) 14(7.3)
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