中华全科医师杂志
中華全科醫師雜誌
중화전과의사잡지
CHINESE JOURNAL OF GENERAL PRACTITIONERS
2015年
2期
111-116
,共6页
赵应梅%戴海燕%杨宾烈%陆继红%朱曼莉
趙應梅%戴海燕%楊賓烈%陸繼紅%硃曼莉
조응매%대해연%양빈렬%륙계홍%주만리
宫内避孕器,铜%随机对照试验%流产,人工
宮內避孕器,銅%隨機對照試驗%流產,人工
궁내피잉기,동%수궤대조시험%유산,인공
Intrauterine devices,copper%Randomized controlled trial%Abortion,induced
目的 了解3种常用宫内节育器(IUD)在人工流产术后即时放置的临床效果和安全性.方法 采用前瞻、随机对照临床研究方法,对2012年1-12月来自上海市浦东医院、浦东新区人民医院、浦东新区公利医院、浦东新区光明中医院4家医院计划生育门诊的1 200例早孕(孕周＜8周)妇女,行人工流产术后即时放置IUD,用抽取内含随机数字的信封方式确定放置IUD的类型,分别为MYCu、TCu380A和宫铜200 IUD 3种.每种IUD均观察400例,随访12个月,采用WHOLTA 2.0生命表法统计3种IUD随访12个月的累计终止率.结果 1 199例完成了12个月的随访,失访1例(0.08％,1/1 200);无子宫穿孔发生.MYCu、TCu380A和宫铜200 IUD的带器妊娠率分别为0.26/百妇女年、0、0.52/百妇女年(x2=1.951,P≥0.2);脱落相关终止率分别为0.26/百妇女年、1.84/百妇女年、2.05/百妇女年(x2=5.539,P =0.066).因症取器率分别为1.26/百妇女年、7.29/百妇女年和2.76/百妇女年,3者差异有统计学意义(x2=21.625,P=0.001),与IUD使用相关的终止率分别为3.25/百妇女年、9.00/百妇女年、5.50/百妇女年,3者差异有统计学意义(x2=12.191,P=0.004);IUD异位发生率分别为1.51/百妇女年、0、0.26/百妇女年,3者差异有统计学意义(x2 =8.649,P =0.014).结论 人工流产术后即时放置MYCu、TCu380A和宫铜200的避孕效果均良好,其中MYCu IUD不易脱落、与IUD使用相关的终止率低、续用率高,但IUD异位发生率较高.
目的 瞭解3種常用宮內節育器(IUD)在人工流產術後即時放置的臨床效果和安全性.方法 採用前瞻、隨機對照臨床研究方法,對2012年1-12月來自上海市浦東醫院、浦東新區人民醫院、浦東新區公利醫院、浦東新區光明中醫院4傢醫院計劃生育門診的1 200例早孕(孕週＜8週)婦女,行人工流產術後即時放置IUD,用抽取內含隨機數字的信封方式確定放置IUD的類型,分彆為MYCu、TCu380A和宮銅200 IUD 3種.每種IUD均觀察400例,隨訪12箇月,採用WHOLTA 2.0生命錶法統計3種IUD隨訪12箇月的纍計終止率.結果 1 199例完成瞭12箇月的隨訪,失訪1例(0.08％,1/1 200);無子宮穿孔髮生.MYCu、TCu380A和宮銅200 IUD的帶器妊娠率分彆為0.26/百婦女年、0、0.52/百婦女年(x2=1.951,P≥0.2);脫落相關終止率分彆為0.26/百婦女年、1.84/百婦女年、2.05/百婦女年(x2=5.539,P =0.066).因癥取器率分彆為1.26/百婦女年、7.29/百婦女年和2.76/百婦女年,3者差異有統計學意義(x2=21.625,P=0.001),與IUD使用相關的終止率分彆為3.25/百婦女年、9.00/百婦女年、5.50/百婦女年,3者差異有統計學意義(x2=12.191,P=0.004);IUD異位髮生率分彆為1.51/百婦女年、0、0.26/百婦女年,3者差異有統計學意義(x2 =8.649,P =0.014).結論 人工流產術後即時放置MYCu、TCu380A和宮銅200的避孕效果均良好,其中MYCu IUD不易脫落、與IUD使用相關的終止率低、續用率高,但IUD異位髮生率較高.
목적 료해3충상용궁내절육기(IUD)재인공유산술후즉시방치적림상효과화안전성.방법 채용전첨、수궤대조림상연구방법,대2012년1-12월래자상해시포동의원、포동신구인민의원、포동신구공리의원、포동신구광명중의원4가의원계화생육문진적1 200례조잉(잉주＜8주)부녀,행인공유산술후즉시방치IUD,용추취내함수궤수자적신봉방식학정방치IUD적류형,분별위MYCu、TCu380A화궁동200 IUD 3충.매충IUD균관찰400례,수방12개월,채용WHOLTA 2.0생명표법통계3충IUD수방12개월적루계종지솔.결과 1 199례완성료12개월적수방,실방1례(0.08％,1/1 200);무자궁천공발생.MYCu、TCu380A화궁동200 IUD적대기임신솔분별위0.26/백부녀년、0、0.52/백부녀년(x2=1.951,P≥0.2);탈락상관종지솔분별위0.26/백부녀년、1.84/백부녀년、2.05/백부녀년(x2=5.539,P =0.066).인증취기솔분별위1.26/백부녀년、7.29/백부녀년화2.76/백부녀년,3자차이유통계학의의(x2=21.625,P=0.001),여IUD사용상관적종지솔분별위3.25/백부녀년、9.00/백부녀년、5.50/백부녀년,3자차이유통계학의의(x2=12.191,P=0.004);IUD이위발생솔분별위1.51/백부녀년、0、0.26/백부녀년,3자차이유통계학의의(x2 =8.649,P =0.014).결론 인공유산술후즉시방치MYCu、TCu380A화궁동200적피잉효과균량호,기중MYCu IUD불역탈락、여IUD사용상관적종지솔저、속용솔고,단IUD이위발생솔교고.
Objective To compare the safety and effectiveness of three types of intrauterine device (IUD) inserted immediately after artificial abortion.Methods A randomized controlled clinical trial was performed in 4 family planning service stations in Pudong New Area from January to December 2012.Total 1 200 eligible women were randomly assigned to receive three types of IUD:MYCu,TCu380A or G-Cu200 (n =400 in each group) immediately after vacuum aspiration.All subjects were followed up for 12 months.The cumulative rates of termination of three IUD after 12 months were analyzed with WHO LTA 2.0 life table.Results Total 1 199 subjects were followed up for 12 months with a drop-out rate of 0.08％ (1/1 200).No any uterine perforation was found.During the 12 months the pregnancy rates with IUD in situ in MYCu,TCu380A and G-Cu200 groups were 0.26/100 women year,0 and 0.52/100 women year,respectively (x2 =1.951,P ≥ 0.2).The rates of expulsion in three groups were 0.26/100 women year,1.84/100 women year and 2.05/100 women year,respectively(x2 =5.539,P =0.066).The remove rates related to bleeding and paining in three groups were 1.26/100 women year,7.29/100 women year and 2.76/100 women year,respectively (x2 =21.625,P =0.001).The discontinuation rates related to IUD use in there groups were 3.25/100 women year,9.00/100 women year and 5.50/100 women year,respectively(x2 =12.191,P =0.004).The rates of Abnormal position in three groups were 1.51/100 women year,0 and 0.26/100 women year,respectively (x2 =8.649,P =0.014).Conclusion Three IUDs inserted immediately after vacuum aspiration are all effective.Among three IUDs,MYCu shows lower expulsion rate,lower discontinuation rate related to IUD use and higher continuous rate; but the abnormal position rate of MYCu is higher than other two types IUD.
