摘要
目的探讨瘢痕子宫患者人工流产术后宫内节育器(intrauterine contraceptive device,IUD)不同置入时间及类型对临床效果的影响。方法选取2017年1月至2019年1月中国人民解放军总医院第六医学中心收治的人工流产术后需置入IUD的瘢痕子宫患者600例,根据患者置入IUD的时间将其分为观察组和对照组,每组各300例。观察组患者在人工流产后即时放置IUD,对照组患者在人工流产后的月经结束4~6 d放置IUD。根据放置IUD的类型将观察组和对照组患者分别再随机分为放置宫型含铜IUD(宫铜200)、T型含铜IUD(TCu380A)、活性γ型IUD三个亚组,各100例。随访12个月,观察每组患者IUD使用效果及相关不良反应。结果随访12个月,3种IUD的累计续用率随使用时间的延长均呈下降趋势,活性γ型IUD续用率相比另2种稍高,但比较无统计学意义(P>0.05);观察组3种IUD累计续用率(96.84%、96.88%、97.94%)相比对照组3种IUD累计续用率(87.23%、90.43%、90.63%)均稍高,但比较差异无统计学意义(均P>0.05);随访期间两组患者置入IUD后所发生的不良反应均随时间的延长而降低,置入活性γ型IUD的患者不良反应发生率低于另2种,但比较差异无统计学意义(P>0.05)。结论瘢痕子宫患者人工流产术后不同时间置入不同类型IUD均能安全有效避孕,但人工流产术后即时放置活性γ型IUD临床效果更好。
Objective To explore the effects of different implantation time and type of intrauterine contraceptive device(IUD)on the clinical effect in patients with scar uterus after induced abortion.Method A total of 600 patients with scar uterus who needed IUD implantation after induced abortion in the Sixth Medical Center of PLA General Hospital from January 2017 to January 2019 were selected.According to the time of IUD implantation,the patients were divided into observation group and control group,with 300 patients in each group.The IUD was placed immediately after the abortion in observation group and 4 to 6 days after the end of menstruation in control group.According to the type of IUD,observation group and control group were respectively and randomly divided into the uterine copper-containing IUD(uterine copper 200),T-type copper-containing IUD(TCu380A),activeγ-type IUD,100 cases each group.Follow-up for 12 months,the effects of IUD application and related adverse reactions were observed in each group.Result After 12 months of follow-up,the cumulative continuation rate of the three IUDs decreased with the extension of use time,and the continuation rate of activeγ-type IUD was slightly higher than that of the other two,but the comparison was not statistically significant(P>0.05).The cumulative continued rates of the three IUDs in observation group(96.84%,96.88%,97.94%)were slightly higher than those in control group(87.23%,90.43%,90.63%),but there were no statistical significance(all P>0.05).The incidence of adverse events after IUD implantation in both groups decreased with time,and the incidence of adverse events in patients with IUD implantation of activeγ-type IUD was lower than that of the other two groups,but the comparison was not statistically significant(P>0.05).Conclusion The implantation of different types of IUD in patients with scar uterus at different time after induced abortion can be safe and effective in contraception,but the immediate implantation of activeγ-type IUD after induced abortion has better clinical effect and is worthy of clinical promotion.
作者
郭旭彦
石晓艺
谢业敏
Guo Xuyan;Shi Xiaoyi;Xie Yemin(Department of Obstetrics,the Sixth Medical Center of PLA General Hospital,Beijing 100037,China)
出处
《中国医学前沿杂志（电子版）》
2021年第5期51-55,共5页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
关键词
瘢痕子宫
人工流产术
置入时间
宫内节育器
临床效果
Scar uterus
Induced abortion
Implantation time
Intrauterine contraceptive device
Clinical effect
