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目的对比4种宫内节育器的临床应用效果及安全性。方法 2010年2月—2011年9月要求放置宫内节育器的育龄健康妇女640例,随机分为A组、B组、C组、D组各160例。A组给予T铜380A,铜表面积380 mm2;B组给予宫铜300,铜表面积300 mm2;C组给予宫铜200,铜表面积200 mm2;D组给予元宫药铜220,铜表面积为220mm2,含吲哚美辛20~25 mg。术前均常规体格检查、妇科检查、盆腔妇科检查,白带正常,排除妇科炎症。月经干净后3~7天,由经过培训的专业技师严格按照宫内节育器技术规范操作,放置后行B超检查,确认放置成功。嘱其放置后1、6、12、24个月复查,24个月后对比四组的带器妊娠情况、脱落或下移情况、不良反应及续用率。计量资料采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果妊娠率A组5.0%、B组6.2%、C组6.2%、D组0。四组带器妊娠率比较差异均无统计学意义(均P>0.05)。脱落或下移A组占6.2%,B组无,C组占8.8%,D组占3.8%,C组脱落或下移情况明显高于B组,比较差异有统计学意义(P<0.05),其余各组间比较差异均无统计学意义(均P>0.05)。续用率A组86.2%,B组93.8%,C组86.2%,D组87.5%,B组续用率高于A组、C组,比较差异均有统计学意义(均P<0.05)。结论不同的宫内节育器有不同的特点,T铜380A带器妊娠率较低、使用时间长,但不良反应较大;宫铜300妊娠率、脱落率低,续用率高;宫铜200妊娠率较高,但不良反应较小;元宫药铜220放置后可降低不规则出血率,用后比较舒适。
Objective To compare the clinical efficacy and safety of four kinds of IUDs. Methods From February 2010 to September 2011, 640 women of childbearing age who requested IUD placement were randomly divided into A group, B group, C group and D group, with 160 cases each. Group A was given T copper 380A with a copper surface area of 380 mm2; Group B was treated with Gong Cu 300 with a copper surface area of 300 mm2; Group C was treated with Gong Cu 200 with a copper surface area of 200 mm2; Group D was given Yuan Gong Yao Cu 220 with a copper surface area of 220 mm2; With indomethacin 20 ~ 25 mg. Preoperative routine physical examination, gynecological examination, pelvic gynecological examination, vaginal discharge normal, excluding gynecological inflammation. Menstrual clean after 3 to 7 days, by trained professional technicians in strict accordance with IUD technical specifications, place after the line B-ultrasound to confirm the placement is successful. Were placed 1, 6, 12, 24 months after the review, 24 months after the pregnancy compared with the four groups of devices, off or down the situation, adverse reactions and the continuation rate. Measurement data using t test, count data using χ2 test, P <0.05 for the difference was statistically significant. Results The pregnancy rate was 5.0% in group A, 6.2% in group B, 6.2% in group C, and 0 in group D. There was no significant difference in pregnancy rate between four groups (all P> 0.05). The rate of shedding or down-shifting in group C was significantly higher than that in group B (6.2% in group A, 8.8% in group C, 8.8% in group D), and the difference was statistically significant (P <0.05) , No significant difference was found between the other groups (all P> 0.05). The follow-up rate was 86.2% in group A, 93.8% in group B, 86.2% in group C and 87.5% in group D, and the recovery rate in group B was higher than that in group A and group C (all P <0.05). Conclusions Different IUDs have different characteristics. T-copper 380A with lower pregnancy rate and longer duration of use, but with a greater adverse reaction; pregnancy rate of Palace copper 300, low exfoliation rate, high recovery rate; Palace copper 200 Pregnancy rate is higher, but the adverse reactions are small; Yuan Gong Yao copper 220 placed to reduce the irregular bleeding rate, after use more comfortable.