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目的:对流产后服务(post-abortion care,PAC)进行临床实践和评价。方法:1 450例因非意愿妊娠在计划生育门诊自愿进行人工流产者,在流产后接受相关的流产后服务,比较患者流产前的一般情况、接受流产后服务用的避孕方案及其相应副作用、坚持避孕方案的时间、重复人工流产的发生率及间隔时间等。结果:所有接受PAC的患者术后均立即采用了避孕措施,术后首月主要采用的避孕方式为口服避孕药(n=573)、屏障避孕(n=551)、曼月乐(n=287)及普通IUD(元宫药铜IUD、活性γ型IUD、TCu220IUD、吉妮致美IUD等)(n=39)。随访12个月后曼月乐组100%坚持使用,普通IUD组使用人数则由最初的39例增至83例,比流产术后增加了1倍以上,主要由原口服避孕药组转入。口服避孕药组的坚持使用率为46.4%。所有坚持随访的女性均未发生随访期间意外妊娠。坚持避孕的各组中,起始有痛经、点滴阴道出血、漏服、环位置下移等不适,均遵医嘱来院处理;随访3个月后各组的不适症状均明显缓解;随访6个月后各组均无不适主诉。结论:科学系统的优质PAC能有效防范重复流产发生,保证避孕效率,从而保护女性的生殖健康。
Objective: To conduct post-abortion care (PAC) clinical practice and evaluation. Methods: A total of 1 450 cases of involuntary pregnancy induced abortion were carried out in unplanned family planning clinics. After abortion, they received related post-abortion services, compared the general situation of patients before abortion, the contraceptive program for abortion services and their corresponding side effects, Adhere to the contraceptive program time, repeat the incidence of abortion and interval time. Results: All contraceptives were administered to all patients who underwent PAC. The first contraceptive methods used in the first month after surgery were oral contraceptives (n = 573), barrier contraception (n = 551), Mirena (n = 287 ) And ordinary IUD (Uterine copper IUD, active gamma IUD, TCu220IUD, Ginny IUD, etc.) (n = 39). After 12 months of follow-up, 100% of the patients in Mirena continued to use it. The number of patients in the normal IUD group increased from 39 in the first trimester to 83, which was more than double that after abortion, mainly from the original oral contraceptives group. Oral contraceptives adherence rate of 46.4%. All follow-up women did not have an unexpected pregnancy during the follow-up period. Insist on the contraception in each group, the initial dysmenorrhea, vaginal bleeding drip, missed service, the ring position down and other discomfort, were prescribed to the hospital to deal with; follow-up 3 months after the symptoms were significantly relieved in each group; followed up for 6 months After each group no complaints. Conclusion: The high quality PAC of scientific system can effectively prevent the occurrence of repeated abortion and ensure the contraceptive efficiency so as to protect female reproductive health.