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目的:总结分析浙江省晚产褥期与经后放置活性宫内节育器(IUD)多中心临床效果比较性研究3年的结果。方法:接受晚产褥组放置对象818例,其中活性γ型IUD 204例,TCu 220C IUD 210例,宫Cu IUD 193例,药铜165 IUD211例;经后组763例,其中活性γ型IUD 195例,TCu 220C IUD 194例,宫Cu及药铜165 IUD各为187例。观察3年使用效果,3年中失访7例,随访率99％以上。结果:晚产褥组3年继续存放率活性γ型IUD92.07/100妇女,TCu220C IUD 86.73/100妇女,宫Cu IUD 84.05/100妇女,药铜165 IUD 81.62/100妇女;经后组3年继续存放率活性γ型IUD 87.18/100妇女,TCu 220C IUD 83.38/100妇女,宫Cu IUD 89.77/100妇女,药铜165 IUD 79.13％,两组的带器妊娠率、脱落率、因症取出率均无统计学差异(P>0.05)。而四种IUD相比较,3年继续存放率活性γ型IUD最高,药铜最低,两种IUD之间有极显著性的差异(P<0.01),因症取出率以TCu 220C IUD最高,其余依次为宫Cu IUD,活性γ型IUD和药铜165 IUD。结论:四种活性IUD均适合于晚产褥期与经后妇女放置。经对晚产褥组观察,放置活性IUD不增加产科并发症,不增加副反应的发生率。对于今后及时落实避孕措施,减少哺乳期妇女妊娠,保障妇女身心健康,将有极为重要的意义。
OBJECTIVE: To summarize and analyze the results of a comparative study of the multi-center clinical effects of late-puerperium and post-operative placement of IUD in Zhejiang Province for 3 years. Methods: There were 818 cases in the late puerperal group, including 204 cases of active γ-type IUD, 210 cases of TCu 220C IUD, 193 cases of uterine Cu IUD and 165 cases of copper IUD211; 763 cases of post-treatment group, of which active γ-type IUD 195 For example, 194 cases of TCu 220C IUD, 187 cases of palace Cu and 165 copper IUD. Observed 3 years of use effect, 3 years lost in 7 cases, follow-up rate of 99%. Results: The rate of activity type IUD92.07 / 100 women, TCu220C IUD 86.73 / 100 women, palace Cu IUD 84.05 / 100 women and drug copper 165 IUD 81.62 / 100 women were kept in the late puerperal group for 3 years. After 3 years Continue to store the rate of active γ-type IUD 87.18 / 100 women, TCu 220C IUD 83.38 / 100 women, Palace Cu IUD 89.77 / 100 women, drug copper 165 IUD 79.13%, with two sets of pregnancy rate, abortion rate, No statistical difference (P> 0.05). Compared with the four IUDs, the highest IUD of active γtype and the lowest drug copper were observed at 3 years, with a significant difference between the two IUDs (P <0.01). The removal rate of TCu 220C was the highest, and the rest Followed by Gong Cu IUD, active γ-IUD and Cu-165 IUD. Conclusion: The four active IUDs are suitable for postpartum and postmenopausal women. After the observation of the late puerpera group, place the active IUD does not increase obstetric complications, does not increase the incidence of side effects. For the timely implementation of contraceptive measures in the future, to reduce the pregnancy of pregnant women to protect women’s physical and mental health, will be extremely important.