【摘要】 目的:探讨宫内节育器(IUD)取出术标准操作程序(SOP)对手术效果的影响,为预防手术并发症提供依据。方法:选择我国中、东、西部不同经济发展水平的6个省,每省随机选取4个县级计划生育服务机构,将所选的县级服务机构随机分成干预组(3600例)和对照组(3600例)。干预组按照SOP进行IUD取出术,对照组按照各服务机构日常的操作完成IUD取出术,比较两组手术过程及结局。结果:干预组手术并发症的发生率(0.59%)低于对照组(1.1%);宫腔操作平均次数(1.1次)少于对照组(1.2次);术中出血量≥5ml比率(2.6%)低于对照组的(5.6%),差异均有统计学意义(P<0.05)。干预组的宫颈准备率(4.0%)低于对照组(4.4%),但差异无统计学意义(P>0.05)。结论:通过对手术医生进行SOP的培训,加强了IUD取出术的规范化操作,有利于手术过程的顺利进行,并降低IUD取出术并发症的发生。更多还原

【Abstract】 Objective:To explore the impacting on effectiveness of standard operation procedure(SOP)about intrauterine device(IUD)removing,and to provide evidence for preventing surgical complications of IUD removing.Methods:The representative sample was selected from six provinces based on different level of economic development in China.In each province,four county-level family planning service stations were selected by the random cluster method and randomly assigned to interventional group(that included 3600cases)and control group(that included 3600cases).In interventional group,the IUD was removed according to SOP.While in control group,the IUD was removed by daily-used technique of each station.Both the operation process and last outcomes were compared between the two groups.Results:The incidence of total surgical complications in interventional group was 0.59%,while that of control group was 1.14%,which had statistically significant difference(P<0.05).The mean number of uterine cavity operation in interventional group was 1.06,and that of control group was 1.15,which had statistically significant difference(P<0.05).During operation,there were 92cases(2.59%)with bleeding amount(≥5ml)in interventional group,but there were 186cases(5.55%)in control group,which also had statistically significant difference(P<0.05).Rate of cervical preparation in interventional group(4.03%)was lower than that of control group(4.38%),but there was no significant different between the two group(P>0.05).Conclusion:The SOP of IUD removing is safe,simple,and effective.The providers trained by SOP can not only improve standard and success of operation of IUD removing,but also can reduce the surgical complications.更多还原