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目的探讨剖宫产术后,意外妊娠进行人工流产时放置节育器的可行性,希望可以为瘢痕妊娠妇女在人工流产后置入节育器提供经验。方法选取2012年6月至2016年6月期间,在我站进行人工流产术后即时放入节育器的妇女和来站作术后随访的外院受术者作为研究对象,共有300例符合标准。将这300例对象划分为三组。其中,剖宫产术时间不足1年的有95例,归为A组。剖宫产术时间超过1年的,归为B组,共有92例。最后,有113例对象没有进行剖宫产术,归为C组。这三组对象人工流产术后,均即时放置IDU(宫内节育器),对比产生的副作用,以及节育器的避孕效果。结果放置宫内节育器1个月后,对比三组的月经量、经期、出血率。与B、C两组相比,A组的几率均比较高。然而,差异不显著,没有统计学意义。在随访期间,所有患者没有出现宫腔黏连、腰腹痛、闭经、白带增多的现象。随着置器时间的增加,副反应率不断减少。置器3~12个月,对比三组的副作用率,差异不明显,P>0.05,无统计学意义。手术半年后,三组因症取出率最高。后期随访中,有1例置器脱落。对比三组在一年中的累计续用率,没有明显差异,P>0.05。三组一年内置器均无妊娠现象。结论针对瘢痕子宫妇女人工人流后,由于存在高度风险,更要重视避孕。剖宫产术后1年内,人工流产术中及时放置节育器是安全、可靠的。
Objective To investigate the feasibility of placement of an IUD when an unexpected pregnancy is induced by cesarean section and hopes to provide experience for women with scar pregnancy after IUD insertion. Methods Between June 2012 and June 2016, 300 women who received IUD immediately after IUD and those who were hospitalized for postoperative follow-up were included in the study. A total of 300 patients were eligible. The 300 subjects were divided into three groups. Among them, cesarean section less than 1 year in 95 cases, classified as A group. Cesarean section for more than 1 year, classified as group B, a total of 92 cases. Finally, 113 subjects did not undergo caesarean section and were classified as Group C. The three groups of patients after the abortion, are placed immediately IDU (intrauterine device), the side effects of contrast, as well as the effectiveness of contraceptive contraception. Results After IUD placement for 1 month, the menstrual volume, menstrual period, and bleeding rate were compared between the three groups. Compared with B and C groups, the odds of A group were higher. However, the difference was not significant and not statistically significant. During follow-up, all patients did not appear intrauterine adhesions, abdominal pain, amenorrhea, vaginal discharge increased phenomenon. As the device time increases, the incidence of side effects continues to decrease. Placement 3 ~ 12 months, compared with the three groups of side effects rate, the difference was not significant, P> 0.05, no statistical significance. Six months after surgery, the three groups had the highest rate of removal due to illness. Follow-up during the follow-up, 1 case of device off. Comparing the three groups in the year of the cumulative renewal rate, no significant difference, P> 0.05. Three sets of one year implants have no pregnancy. Conclusion After artificial abortion of women with scar uterus, contraception should be paid more attention due to the high risk. Within one year after cesarean section, it is safe and reliable to place the IUD in time in abortion.