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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。
Objective To understand the incidence of side effects in women using various intrauterine device (IUD) in Jiangsu Province. Methods A cross-sectional survey was performed on the incidence of side effects in 12,036 women of childbearing age using IUD in Jiangsu Province. Results The overall incidence of side effects was 21.02%, with a 18.29% incidence of bleeding / pain (bleeding / menstrual problems, lower abdominal pain and back pain). After adjustment for age, educational level and live births, the risk of bleeding / menstrual problems in IUD users in Central and Northern Jiangsu were 1.44 times (95% CI: 1.28 to 1.62) and 2.16 times 95% CI: 1.87 ~ 2.50). Conclusions The incidence of side effects in IUD women in Jiangsu Province is high, with obvious regional differences. The highest incidence of bleeding / pain is still the focus of side effects prevention and treatment. IUD should be placed strictly on the indications and contraindications to choose the right IUD; recommended IUD containing Indomethacin, to strengthen regular abortion of many abortion women follow-up and monitoring, timely detection and standardization of treatment.