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目的:考察喹喃克林女性非手术绝育(QS)术大规模临床使用的安全性、可靠性及可接受性。方法:2007年3月—2010年7月,在贵州省内募集6 000例自愿接受QS的妇女,即:将7粒(252 mg)喹喃克林小丸放入改良的T-铜宫内节孕器(IUD)放置器内,并于月经干净后3～7 d或分娩、人工流产后6周将小丸置入子宫。4周后完成第2次放药。术后3,6,12,24个月进行随访。结果:回收随访表5 780份,妊娠表88份,随访时间最长1 248 d。不良反应主要表现为阴道黄色分泌物、头晕、乏力、月经不调等,未见严重不良反应。绝育有效率为98.5%,上药状态和上药次数影响成功率。结论:QS费用低廉,操作简便、无创、无痛、不良反应小、更易为自愿绝育妇女和临床医生所接受。术前体检排除禁忌证、产后6周或月经后3～7 d上药、2次上药、术后平躺2 h和术后避孕3个月有利于提高QS的成功率。QS的推广对于提高女性绝育的接受程度和降低计划生育手术费用都有着积极作用。
Objective: To investigate the safety, reliability and acceptability of large-scale clinical use of quinoclitin female non-surgical sterilization (QS). Methods: From March 2007 to July 2010, 6,000 women who volunteered to receive QS were enrolled in Guizhou Province, namely, 7 (252 mg) quinacrine beads were placed in a modified T-copper intrauterine segment IUD placement device, and after menstruation clean 3 ~ 7 d or childbirth, 6 weeks after artificial abortion pellets into the uterus. After 4 weeks to complete the second release of drugs. Follow-up was performed at 3, 6, 12 and 24 months after operation. Results: A total of 5780 follow-up questionnaires and 88 pregnant pregnancies were collected. The longest follow-up period was 1248 days. Adverse reactions mainly manifested as vaginal discharge, dizziness, fatigue, irregular menstruation, no serious adverse reactions. Sterilization efficiency was 98.5%, on the drug status and the number of drugs on the success rate. Conclusion: QS is cheap, easy to operate, noninvasive, painless and with less adverse reactions. It is more easily accepted by women and clinicians who voluntarily sterilized. Preoperative physical examination to exclude contraindications, postpartum 6 weeks or 3 to 7 days after menstruation on the drug, 2 on the drug, 2 h after surgery and postoperative contraception 3 months is conducive to improving the success rate of QS. The promotion of QS plays a positive role in improving the acceptance of female sterilization and reducing the cost of family planning surgery.