CAJ | 학술논문

目的：探讨左炔诺孕酮宫内节育系统（曼月乐）对育龄期妇女的节育效果及安全性。方法随机选取我院育龄期要求节育妇女165例作为研究对象，根据采用不同的节育器系统将患者分为两组，研究组（85例）采用曼月乐节育器，对照组（80例）采用宫铜节育器，组间比较节育效果和不良反应状况。结果研究组带器妊娠率、脱环率稍低于对照组，避孕成功率稍高于对照组，但两组比较差异无统计学意义（P ﹥0.05），两组闭经、绝经期综合征和疲乏率比较差异亦无统计学意义（P ﹥0.05），但研究组副作用（月经量增多、不规则子宫出血和下腹痛）发生率均明显低于对照组，月经量评分、痛经程度评分和子宫内膜厚度均明显低于对照组，两组比较差异具有显著性（ P ﹤0.05），血清促血管生成素-1、基质金属蛋白酶9和血管内皮生长因子（VEGF）水平显著低于对照组，满意率明显高于对照组，两组比较具有明显差异（P ﹤0.05）。结论宫铜与曼月乐节育效果相当，但与传统宫铜节育器相比，曼月乐通过降低子宫内膜相关因子的释放以减轻置入节育器后子宫异常出血、疼痛等副作用，提高节育满意率。
목적：탐토좌결낙잉동궁내절육계통（만월악）대육령기부녀적절육효과급안전성。방법수궤선취아원육령기요구절육부녀165례작위연구대상，근거채용불동적절육기계통장환자분위량조，연구조（85례）채용만월악절육기，대조조（80례）채용궁동절육기，조간비교절육효과화불량반응상황。결과연구조대기임신솔、탈배솔초저우대조조，피잉성공솔초고우대조조，단량조비교차이무통계학의의（P ﹥0.05），량조폐경、절경기종합정화피핍솔비교차이역무통계학의의（P ﹥0.05），단연구조부작용（월경량증다、불규칙자궁출혈화하복통）발생솔균명현저우대조조，월경량평분、통경정도평분화자궁내막후도균명현저우대조조，량조비교차이구유현저성（ P ﹤0.05），혈청촉혈관생성소-1、기질금속단백매9화혈관내피생장인자（VEGF）수평현저저우대조조，만의솔명현고우대조조，량조비교구유명현차이（P ﹤0.05）。결론궁동여만월악절육효과상당，단여전통궁동절육기상비，만월악통과강저자궁내막상관인자적석방이감경치입절육기후자궁이상출혈、동통등부작용，제고절육만의솔。
Objective:To investigate the contraceptive effect and safety analysis of Mirena for childbearing women. Methods:165 cases of childbearing women required contraception were randomly selected as research subjects,and accord-ing to different IUD systems,all were divided into the two groups,with study group(85 cases)given Mirena intrauterine device,and the control group(80 cases)by uterus copper IUD,and contraceptive effect and adverse reaction conditions were compared between the groups. Results:Pregnancy and removal ring rate of the study group were slightly lower than those of the control group,contraception success rate was slightly higher than that of the control group,but it had no statis-tically significant difference between the two groups(P ﹥ 0. 05),Amenorrhea,menopausal syndrome and fatigue rate be-tween groups had no statistically significant differences(P ﹥ 0. 05),but the side effects rates(menorrhagia,irregular uter-ine bleeding,and abdominal pain)of study group were significantly lower than those of the control group,menstrual quanti-ty scores,dysmenorrhea degree score and endometrial thickness were significantly lower than that of the control group, which had significant difference between the two groups(P ﹤ 0. 05),the levels of serum angiopoietin-1,matrix metallopro-teinase 9 and vascular endothelial growth factor were significantly lower than those of the control group,satisfactory rate was significantly higher than that of the control group,which had significant difference between two groups(P ﹤ 0. 05). Con-clusion:The uterus copper and Mirena contraceptive have quite good efficacy,but compared with uterus copper IUD,Mire-na reduces side effects of abnormal uterine bleeding,pain after insertion IUD contraception by reducing endometrial related factor release,which improves the satisfaction rate.