简介:摘要目的找出已接受避孕知识宣教的育龄女性1年内再次意外妊娠,重复流产的原因。寻找对策,降低育龄女性重复流产率。方法对于2012年7月至2013年6月我院6852例因意外妊娠要求人工流产(以下简称人流)的对象,每例患者术前均行集体避孕知识宣教或个体咨询,术后四次随访(即术后1、3、6、12个月),随访形式为门诊复诊或电话随访,指导或督促正确避孕,不断补充避孕药具。如在该人群中发生一年内再次意外妊娠重复流产,则在第二次人流手术前进行个案登记。登记内容包括年龄、婚姻状况,我院第一次流产时间,当时孕产次,人流原因,是否接受避孕知识宣教,宣教形式(集体宣教或个体咨询),第二次流产时间,再次意外妊娠原因。如在外院手术,同样进行相应项目登记。结果我院2012年7月至2013年6月1年内共行人流手术6852例。有313例女性在1年内重复流产,1年内重复流产率为4.6%,符合PAC(Post-AbortionCare,即流产后关爱)工作总要求。分别为148例女性在术后半年内再次意外妊娠,重复人工流产占47.3%;165例在术后6~12个月内重复流产,占52.7%。其中接受宣教形式为个体咨询的171例,集体宣教138例,集体宣教结合个体咨询者2例;已婚者132例,占42.4%;未婚者179例,占57.2;离异未再婚者2例,占0.6%;已育者107例,占34.2%,未育者206例,占65.8%。该人群在第一次人流手术时,未避孕者高达221例,占70.6%。经过避孕指导及咨询后,在重复手术时再次调查,未避孕降至105例,仅占33.5%。结论抓住人工流产手术服务时机,及时对育龄人群进行生殖健康教育,改进宣教形式,提高宣教质量,提供多种高效、长效、方便,副作用少的避孕方法,加强术后随访及咨询等,多种措施联合能有效提高育龄人群的避孕意识,降低重复人工流产率。
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简介:摘要COVID-19 has become a pandemic with strong influence on health systems. In many cases it leads to a disruption of rehabilitation service provision. On the other hand, rehabilitation must be an integral part of COVID-19 management. Rehabilitation for COVID-19 should start from acute and early post-acute care and needs to be continued in the post-acute and long-term rehabilitation phase. Of course, it should follow specific safety protocol. Additionally, rehabilitation must be kept available for all other people who are in need. From the perspective of health system, the Global Rehabilitation Alliance urges decision makers to ensure that rehabilitation services will be available for all patients with COVID-19 in the acute, post-acute and long-term phase. Additionally, it must be ensured that all other persons with rehabilitation need have access to rehabilitation services. Rehabilitation services must be equipped with personal protection equipment and follow strict hygiene measures. In particular, rehabilitation must be accessible for vulnerable populations. For that reason, rehabilitation must be kept a health priority during the COVID-19 pandemic and given adequate financial resources. Last but not least, scientific studies should be performed to clarify the impact of the pandemic on rehabilitation services as well as on the needs for rehabilitation of COVID-19 patients.