摘要
目的：观察长期放置ＴＣｕ２２０Ｃ宫内节育器（ＩＵＤ）的子宫内膜病变情况，探讨其安全性。方法：随机选择放置ＴＣｕ２２０ＣＩＵＤ５～１２年的妇女１００例为ＩＵＤ组，用宫腔镜定位取ＩＵＤ压迹处及压迹外１ｃｍ处的子宫内膜；以年龄配比选取１００例未曾放置ＩＵＤ妇女（对照组）的子宫内膜为对照。两组内膜常规制片，ＨＥ染色后光镜下进行形态计量。结果：压迹外１ｃｍ处子宫内膜基本正常，所见病变皆局限于压迹处，炎症各例皆有，以淋巴细胞浸润为主，深度为０．９１～１．２０ｍｍ。有内膜萎缩的病例，放置ＩＵＤ≥５年、＜１０年者有２５％，范围０．８１ｍｍ２；１０～１２年者有７１％，范围１．５０ｍｍ２。有内膜纤维化的病例，≥５年、＜１０年者有１８％，范围１．８７ｍｍ２；１０～１２年者全部有纤维化，范围２．０４ｍｍ２。ＩＵＤ组皆未见过度增生及恶变。放置１０～１２年者皆有出血坏死。ＩＵＤ组皆有内膜发育不同步现象。结论：ＴＣｕ２２０ＣＩＵＤ放置５～１２年是安全的，有抗生育作用；放置１０年后内膜有出血坏死及纤维化，如有临床症状以取出为佳。
Objective:ToobservethepathologicalchangesofendometriuminwomenusingTCu220Cintrauterinedevices(IUD)for5～12years,andtojudgeitslongtermsafety.Methods:AhundredwomenusingTCu220CIUDfor5～12yearswererandomlyselectedasIUDgroup.SamplesofendometriumfromthesitescompresedbyIUDand1cmapartweretakenunderhysteroscopyduringproliferativephase.Another100womenmatchedinagebutnotIUDusersservedascontrolgroup,andendometriumsweretakenbycuretage.Althesampleswerestudiedformorphometry.Results:AlpathologicalchangeswerelocalizedintheareasofendometriumindirectcontactwithIUDbutnottheadjacentareas.InflammatoryreactionsmainlylymphocytesinfiltrationwereseeninalIUDsampleswithdepthof0.91～1.20mm.Atrophywasseenin25%ofthecasesusingIUDfor5～10yearswithanaverageareaof0.81mm2,whilein71%ofthoseusingIUDfor10～12yearswithanareaof1.50mm2.Fibrosiswasshownin18%ofthecasesusingIUDfor5～10yearswithareaof1.87mm2,and100%in10～12yearswithareaof2.04mm2.Therewasnohyper-prolifera-tionandmalignantchangesinIUDgroup.HemorhageandnecrosisexistedinalcasesusingIUDfor10～12years.IntheIUDgroupalthecasesshowedasynchronizationofendometrium.Conclusion:ItissafeforwomenusingTCu220CIUDfor5～12years.SinceendometrialhemorhageandnecrosiswereshowninwomenusingIUDover10years,itisbetertoremovetheIUDafter10yearsiftheyhaveclinicalsymptoms.
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
1996年第9期519-522,共4页
Chinese Journal of Obstetrics and Gynecology
基金
国家计划生育委员会八五攻关课题
