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目的探讨人工流产(人流)术后即时放置吉妮致美、活性γ型、TCu宫内节育器(IUD)和左炔诺孕酮宫内缓释系统(LNG-IUS)的安全性和有效性。方法收集2012年3月至2013年9月本院行人流术、并自愿于术后即时放置IUD的女性215例为研究对象,其中术后放置吉妮致美IUD 75例、活性γ型IUD65例、TCu IUD 30例、LNG-IUS 45例,分别于放置后1、3、6个月时随访,观察IUD使用情况、月经变化/阴道出血模式及副反应等,分析人流术后即时放置IUD的临床效果。结果放置后6个月内,4种IUD带器妊娠率、IUD相关脱落率、医疗原因取出率和续用率比较,差异均无统计学意义(P>0.05);放置后3个月内,4种IUD的月经模式改变(包括出血时间、点滴出血时间及总出血时间)比较,差异有统计学意义(P<0.05),其中吉妮致美和活性γ组出血时间短于TCu组和LNG-IUS组(P<0.05);4种IUD月经量改变、经期延长(周期缩短)及疼痛率比较,差异有统计学意义(P<0.05),其中LNG-IUS组痛经改善好于其他各组(P<0.05)。结论4种IUD在人流术后即时放置安全、可行、有效;吉妮致美和活性γ组IUD月经时间短于TCu组,LNGIUS相对于其他3种IUD可以有效缓解痛经症状,有助于提高妇女对放置IUD的接受性和满意度。
Objective To investigate the safety and efficacy of immediate delivery of gefitinib, active γ, TCu intrauterine device (IUD) and levonorgestrel intrauterine sustained release system (LNG-IUS) after artificial abortion (abortion). Methods A total of 215 female patients who voluntarily placed IUD in our hospital from March 2012 to September 2013 were enrolled. Among them, 75 were Ginny IUD, 65 were active γ-type IUD, 30 cases of TCu IUD and 45 cases of LNG-IUS were followed up at 1, 3, and 6 months after placement. The IUD usage, menstrual changes / vaginal bleeding patterns and side effects were observed. The clinical data of IUD immediately after abortion effect. Results Within 6 months after placement, there was no significant difference in pregnancy rate, IUD-related exfoliation rate, recovery rate of medical causes and recovery rate among 4 IUD devices (P> 0.05). Within 3 months after placement, There were significant differences in the menstrual patterns (including bleeding time, drip time and total bleeding time) between the four IUDs (P <0.05), and the bleeding time of Gynite to the United States and active γ group was shorter than that of TCu group and LNG- IUS group (P <0.05). There were significant differences in menstruation, duration of menstruation (shortening of period) and pain rate among 4 kinds of IUDs (P <0.05). The improvement of dysmenorrhea in LNG-IUS group was better than that in other groups P <0.05). Conclusions The four kinds of IUDs are safe, feasible and effective immediately after abortion. The IUD menstrual duration in Gynnetogenic and active Gamma groups is shorter than that in TCu group. Compared with the other three IUDs, LNGIUS can effectively relieve the symptoms of dysmenorrhea, Acceptance and satisfaction of placing IUDs.