利用两水平模型探讨IUD因出血/疼痛取出的影响因素

摘要

Objective To examine the factors associated with IUD removal due of bleeding/pain. Methods A nested case-control analysis is performed using data of " study on influencing factors and prevention strategy on IUD failure". 363 cases with removal due to bleeding/pain and 16235 controls with the IUD in place within one year postinsertion are included. Two-level logistic regression model was used to analyze the factors.rnResults Two-level logistic regression analysis indicate that IUD types, educational level, dysmenorrhea, strenuous activity within one week postinsertion in the first level, and ' complications related to IUD operation in 2004' in the second level was associated with removal due to bleeding/ pain. Conclusion The findings may help family planning providers inrncounseling and practice.%目的 了解宫内节育器( IUP)因出血和/或疼痛取出的影响因素.方法 本文使用“十五”国家科技攻关课题“宫内节育器失败原因及预防技术对策的研究”子课题的数据进行巢式病例对照研究.363位对象因出血和/或疼痛取出IUD为病例组,16235位对象完成1年随访且未发生任何结局为对照组.采用两水平logistic回归模型进行分析.结果 两水平模型分析结果显示1水平变量IUD种类、文化程度、痛经、置器后剧烈活动、服务机构类别,以及2水平变量“2004年IUD放取手术并发症数”是IUD因出血/疼痛取出的危险因素.结论 加强对服务人员的技术培训,置器时了解使用者的生物学特征,针对不同特征的对象选择合适的IUD,以降低IUD的因出血和/或疼痛取出率.