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目的探讨高危人群人工流产术后立即放置宫内节育器(intrauterine device,IUD)或口服复方短效避孕药,对人工流产后出血、感染、月经恢复、宫腔粘连以及再次意外妊娠的影响。方法将要求终止早孕的重复(≥3次)或高危人工流产者400例分为两组,每组200例。观察组人工流产术后立即放置圆形含铜含吲哚美辛IUD,对照组人工流产术后立即口服屈螺酮炔雌醇片避孕。结果两组术后出血量、出血时间、术后感染情况比较差异无统计学意义(P>0.05),而两组术后月经恢复,闭经、痛经、宫腔粘连,术后12个月内意外妊娠的发生情况比较差异有统计学意义(P<0.05)。结论高危人群人工流产后立即采取高效避孕措施是安全、可靠、有效的。IUD在高效避孕的同时还有助于术后月经恢复,减少闭经痛经发生,预防宫腔粘连,降低术后12个月内再次意外妊娠的发生。对于短期无生育要求(指2年内无生育计划)者,建议人工流产术后立即放置IUD。
Objective To investigate the effect of intrauterine device (IUD) or oral short-acting contraceptive compound (IUD) immediately after induced abortion in high-risk population on post-abortion bleeding, infection, menstruation recovery, intrauterine adhesions and re-unexpected pregnancy. Methods Four hundred repeat-onset (≥3) abortions of early pregnancy and high-risk induced abortion were divided into two groups of 200 in each. In the observation group, the round copper-containing indomethacin IUD was placed immediately after the induced abortion, and the contraceptive was given orally to the control group of drospirenone ethinyl estradiol immediately after the induced abortion. Results There was no significant difference in the postoperative bleeding, bleeding time and postoperative infection between the two groups (P> 0.05). However, the postoperative menstruation recovery, amenorrhea, dysmenorrhea, intrauterine adhesions and the accident within 12 months after operation The incidence of pregnancy was significantly different (P <0.05). Conclusion It is safe, reliable and effective to take effective contraception immediately after induced abortion in high risk population. IUD contraception can also help postoperative menstrual recovery, reduce the incidence of dysmenorrhea, prevent intrauterine adhesions, and reduce the incidence of unwanted pregnancies within 12 months after operation. For short-term non-reproductive requirements (refer to 2-year non-birth planning), IUD placement is recommended immediately after the abortion.