Norplant皮下埋植避孕法使用7年临床效果评价

586例使用Norplant皮下埋植避孕法,至1992年5月31日全部满5年,其中273例接受者要求延长使用,至1994年5月31日全部满7年。123例在使用满5年取出第一组埋植剂同时埋入第二组埋植剂。使用第一组埋植剂共发生23例妊娠,其中7例发生在使用6～7年,5年累计妊娠率为2.73％,持续使用率为79.18％。第二组接受者无一例妊娠。Norplant皮下埋植避孕法效果 可靠,可延长使用2年。主要副反应为月经紊乱,但随着使用时间延长逐渐好转。第一组接受者在使用头6个月,60％妇女诉说有月经问题,而使用第二组埋植剂的妇女,在初6个月随访时,2/3接受者诉说月经情况与使用第一组埋植剂时的第5年情况相类似,比较规律,这说明靶器官经过长期持续甾体激素作用已产生了适应性变化。     

深圳地区TCu220IUD、γ-IUD、VCu200IUD多中心随机比较研究

目的:对TCu220IUD、γ-IUD、VCu200IUD在深圳地区育龄妇女中使用的有效性、安全性进行评价,为筛选适合深圳地区育龄妇女使用的IUD提供科学依据。方法:采用前瞻性、多中心随即对比临床研究方法,对900例适龄妇女由经过专门培训的医生放置上述3种IUD各300例,于置器后3、6、12、24个月随访,并对其中300例增加了60、84个月随访,以寿命表方法统计3种IUD的终止情况。结果:3种IUD放置24个月后的带器妊娠率分别为TCu220IUD1.00/100妇女、γ-IUD 0.67/100妇女、VCu200IUD 0.33/100妇女;脱落率分别为TCu220IUD 3.33/100妇女、γ-IUD2.67/100妇女、VCu200IUD 1.67/100妇女,因症终止率分别为TCu220IUD 6.00/100妇女、γ-IUD 2.00/100妇女、VCu200IUD 4.00/100妇女,3组比较无统计学差异,均显示出良好的避孕效果和可接受性。300例5年和7年的随访表明,3组带器妊娠、脱落及因症终止率未随时间延长而明显增加;但γ-IUD发生嵌顿的可能性增加;VCu200IUD 7年后出血、疼痛等副反应增多。结论:TCu220IUD、γ-IUD、VCu200IUD避孕效果可靠、并发症少、可接受性好,均的作为深圳地区推荐使用的IUD。     

ML250与ML375宫内节育器的比较性评价

主要评价作者使用MLCuIUD十余年的经验。1978～1984年共1254名妇女放置MLCu250,1983～1986年754名妇女放置MLCu375。放置时间包括月经间期,人工流产、自然流产后3～6周,及产后6～8周。36例(1.7%)随访资料不全。七年内总计使用63383妇女月,MLCu250为37962妇女月,MLCu375为25421妇女月。两组在孕次、产次方面相似,绝大多数年龄为25～35岁,并有1～2次妊娠,未孕妇3%。使用4年两种IUD 的临床表现相似,每100妇女脱落率MLCu250为6.8,MLCu375为7.4;因症取出率分别为11.6与15.9。只有累积妊娠率MLCu375比MLCu250显著为低,四年末各为3.0和5.4/100妇女(P=0.012)。按Pearl 妊娠指数MLCu250为1.52/100妇女年,MLCu375为0.7/100妇女年。共有7例异位妊娠,4例为MLCu250(0.13/100妇女),3例为MLCu375(0.14/100妇女)。有39名妇女因怀疑盆腔炎(PID)而     

含吲哚美辛MYCu宫内节育器多中心临床研究

目的:探讨放置MYCu宫内节育器(IUD)的临床效果。方法:在我国不同地域选择8个省的49个中心放置MYCuIUD5200例,放置后1、3、6、12个月随访。结果:放置满12个月者纳入统计分析共4998例,累积带器妊娠率0.29/百妇女年,累积脱落率0.24/百妇女年,因出血/疼痛累积终止率1.56/百妇女年,与使用IUD有关的累积终止率2.08/百妇女年;8个省因与使用IUD有关的累积终止率3.51/百妇女年～1.00/百妇女年,差异无统计学意义(P﹥0.05);放置后不良反应主要为月经异常、不规则出血、腰腹疼痛和白带增多,随放置时间延长而逐渐缓解。结论:MY-CuIUD避孕效果可靠,脱落率低,不良反应发生率低,是比较理想的IUD。     

新型宫内节育器GyneFix、HCu280与TCu220的临床效果比较

目的:对比新型宫内节育器GyneFix、HCu280与TCu220型宫内节育器的临床使用效果。方法:无胎次区别于经后7天内随机放置GyneFix、HCu280和TC220宫内节育器,随访满1年。结果:放置GyneFix IUD的1年带器妊娠率为1.45/百妇女/年,脱落率为6.57/百妇女/年,因症取出率为2.39/百妇女/年,续用率为94.45/百妇女/年;放置Hcu280的1年带器妊娠率为0.96/百妇女/年,脱落率为3.52/百妇女/年,因症取出率为21.84/百妇女/年,续用率为84.55/百妇女/年;放置Tcu220的1年带器妊娠率为6.02/百妇女/年,脱落率为3.12/百妇女/年,因症取出率为22.50/百妇女/年,续用率为82.45/百妇女/年。结论:放置GyneFix无支架宫内节育器出血少,腹痛、续用率及避孕效果均高于Hcu280和Tcu220,是今后开发和推广使用的方向。     

皮下埋植剂Norplant避孕5年的应用观察

本文从1988年10月3日～1994年5月31日观察接受Norplant Ⅰ型皮下埋植剂避孕满5年的妇女400例。5年累积妊娠率0.52/100接受者,其中1例宫内妊娠发生在使用52个月时,1例左卵巢妊娠发生在使用36个月时,可能与其患肺结核使用利福平治疗7个月而未加用其他避孕措施有关。月经紊乱是主要终止原因,5年中因月经问题取出埋植剂117例,占总取出数的82.63％,因其他医学问题取出25例,占17.12％,5年累积续用率为64.76/100接受者。835次埋植术及取出术均无伤口感染。观察结果表明Norplant皮下埋植避孕是一种长效、高效、安全可逆的避孕方法。     

宫型含药和宫型药铜IUD的临床研究

选择1600例健康妇女,放置宫型含药IUD和宫型药铜IUD各800例,进行1年的临床随访,并从每组抽取7例妇女测定放置前及放置后1、3、6、12个月的经血量进行比较研究。结果显示:宫型含药IUD的12个月累积妊娠卑、脱落率、因症取出率、续用率及副反应率分别是1.18/100妇女、0.94/100妇女、0.12/100妇女、97.76/100妇女、28.06％;宫型药铜IUD分别为0.25/100妇女、1.25/100妇女、0.13/100妇女、98.37/100妇女、30.07％。宫型含药IUD和宫型药铜IUD的经血量放置后均比放置前低(P<0.05)。可见两种IUD的事件率均较低,续用率较高,两者相比,宫型药铜的妊娠率又显著低于宫型含药IUD(P<0.05)。     

4999例MCuⅡ功能性宫内节育器多中心临床观察

目的探讨MCuⅡ功能性宫内节育器(intrauterine contraceptivedevice,IUD)的临床效果和安全性。方法在我国不同地域选择9省91个中心的健康育龄妇女放置MCuⅡIUD,放置后1、3、6、12月随访。结果放置满12个月,MCuⅡIUD累积带器妊娠率为0.29/百妇女年,累积脱落率为0.28/百妇女年,因出血/疼痛累积终止率2.15/百妇女年,各省间同项停用率差异无统计学意义(P>0.05);放置后不良反应主要为月经异常、不规则阴道出血、腰腹疼痛和白带增多,随放置时间的延长逐渐缓解。结论 MCuⅡIUD避孕效果好,脱落率低,不良反应发生率低,是比较理想的IUD,推广使用中需规范临床操作。     

活性金属单环165推广试验研究

为进一步验证活性金单环165在推广中的临床效果,于1991.1～1992.8在上海市15个手术点作为常规放置活性金单环165共4998例,进行了3～6个月和12个月两次随访,随访结果:3～6月时续放率为95.91/100妇女,带器妊娠率0.42/100妇女,脱落率3.06/100妇女;因症取出率0.24/100妇女。12月时续放率为93.80/100妇女,带器妊娠率1.05/100妇女,脱落率4.26/100妇女,因症取出率为0.36/100妇女。3～6月随访时,有副反应人数占27.90％。12月随访时下降至14.98％,以上各指标均明显低于金单环。本研究结果提示该环临床效果明显高于金单环。上海市从1989年开始广泛放置该环,1990年人工流产率有显著下降,全年少做人工流产4万余人次。活性金单环165具有长期放置,随访方便,价格经济,放取技术易普及,推广中不需特殊培训,临床效果佳等优点,易为广大妇女所接受。     

放置MCu功能性宫内节育器60个月观察

目的追踪观察放置MCu功能性宫内节育器60个月的临床使用效果。方法Ⅰ组放置MCu功能性宫内节育器600例,Ⅱ组放置GT300型含铜宫腔形宫内节育器600例,追踪观察使用60个月的带器妊娠率、脱落率、因症取出率及续用率,于放置后1、3、6、12、24、36、48、60个月(1个月随访观察不纳入比较)各随访观察一次。结果放置满60个月时,MCu IUD和GT300 IUD的带器妊娠率分别为2.15/百妇女年、11.19/百妇女年;脱落率分别为0.17/百妇女年、8.96/百妇女年;因症取出率分别为1.52/百妇女年、11.15/百妇女年;续用率分别为92.67/百妇女年、60.33/百妇女年。两组差异均有统计学意义(p<0.05)。两组放置后3、6、12、24、36、48、60个月追踪观察副反应比较均有统计学意义(p<0.05)。结论 MCu IUD的使用效果好,5年续用率高,是比较理想的IUD,值得临床推广使用。     

Long-term reversible contraception: Twelve years of experience with the TCu380A and TCu220C

Few data on the long-term efficacy of intrauterine devies (IUD) are available, and this article reports on the final 12-year experience with the TCu220C and TCu380A devices from two randomized, multicenter trials conducted in 24 centers. A total of 3,277 and 1,396 women, respectively, were recruited for use of each device between 1981 and 1986 and followed at 3, 6, and 12 months after insertion and yearly thereafter. At the end of 12 years, a total of 17,098 women-years of experience had been accumulated for the TCu220C and 7,159 women-years for the TCu380A. The cumulative 12-year intrauterine pregnancy rates were 7.0 (standard error [SE] 0.6) per 100 women for the TCu220C and 1.9 (SE 0.5) for the TCu380A (p < 0.001). Pregnancy rates were highest in the first years after insertion; the TCu220C had a consistently higher annual pregnancy rate than did the TCu380A at all intervals since insertion. No pregnancies were reported with the TCu380A after 8 years of use. Total medical removals were approximately 6% in the first year and dropped to approximately 4% per year for each device for up to 12 years of use (cumulative 12 year rates were 37.3 [SE 1.3] and 40.2 [SE 2.1] per 100 women for the TCu220C and TCu380A devices, respectively). The overall continuation rate at all intervals since insertion was higher with the TCu220C device, mainly due to higher removal rates for nonmedical reasons with the TCu380A. The cumulative ectopic pregnancy rates were 0.7 and 0.4 for the TCu220C and TCu380A, respectively. Pregnancy rates were higher in the Chinese compared with the non-Chinese centers for both devices, though the greater efficacy of the TCu380A was apparent in both groups of centers. The total medical and nonmedical removal rates were lower in the Chinese compared with the non-Chinese centers, and did not show any substantial differences between the devices. We conclude that both devices are safe and effective for at least 12 years of use and the low pregnancy rate with the TCu380A is comparable with that reported in the United States among women who had undergone tubal sterilization. The very high efficacy of the TCu380A makes it the IUD of choice, and it can be considered as a potentially reversible, nonsurgical alternative to sterilization for women requiring very long-term pregnancy protection.     

活性γ-Ⅱ型宫内节育器避孕效果观察

目的:观察活性γ-Ⅱ型宫内节育器(IUD)的避孕效果。方法:随机放置活性γ-Ⅱ型IUD与MLCu375 IUD各854例,进行为期2年的随访观察。结果:24个月的带器妊娠率、IUD脱落率、因症取出率、累积续用率,活性γ-Ⅱ型IUD为每百妇女年0.7、0.23、2.22、96.7,MLCu375 IUD为每百妇女年0.47、4.44、7.02、87.9,带器妊娠率比较无差异(P(0.05),活性γ-Ⅱ型IUD脱落率及因症取出率低于MLCu375 IUD(P(0.05),累积续用率高于MLCu375 IUD(P(0.05)。结论:活性γ-Ⅱ型IUD较MLCu375 IUD具有脱落率和因症取出率低,累积续用率高等优点。     

Spontaneous abortion in Italy: social differences and temporal trends

Spontaneous abortion in Italy between 1980 and 1993 has been analysed with particular reference to temporal trends and to indicators of social status (level of education and occupation of the women). Each year about 50,000 spontaneous abortions are notified in Italy and the trend is slightly increasing. The national rate passed from 8 to 9 spontaneous abortions per 100 conceptions during the period 1983-93. Geographically, the rate decreases from North to South (respectively from 11-12 to 6-8 spontaneous abortions per 100 known conception in 1993). The national rate of spontaneous abortion is slightly higher for women with little or no education: 9.0 per 100 known conceptions for women with no or primary school certificate (schooling from 6 to 10 years), 8.8 for those with lower school certificate (ages: 11 to 13 years) 7.8 for high school certificate (ages: 14 to 18 years) and 8.3 for university degree, in 1991. There were no significant differences between occupations, excepting agricultural workers who had the lowest rate: 4.1 per 100 known conceptions compared with 8.2 for women employed in industry, 9.3 for other occupations and 8.9 for housewives, students or the unemployed, in 1991. However, maternal age is confirmed to be a more important risk factor: the risk of spontaneous abortion increased from 6-7 per 100 known conception among women aged less than 30 to 20 per 100 among women aged 40 or more. The same effects are found in a logistic regression model.     

深圳市2008年高龄产妇妊娠结局分析

目的:探讨深圳市高龄产妇与不良妊娠结局的关系,为妇幼卫生政策提供依据。方法:对深圳市妇幼信息系统2008年深圳市161362例产妇资料进行分析,采用单因素分析比较不同年龄段产妇基本状况及妊娠结局,采用多因素Logistic分析产妇高龄与早产及低出生体重的关系,分析软件使用SPSS15.0。结果:深圳高龄产妇的比例逐年上升;单因素分析表明,随产妇年龄的增加,初产妇比例下降,孕前超重、肥胖比例增加,剖宫产比例增加;40岁以上产妇分娩婴儿的平均出生体重显著低于30～34岁以及35～39岁产妇,平均孕周显著低于其他年龄组,早产儿、低出生体重儿、小于胎龄儿比例、围产儿死亡率在产妇各年龄段分布呈中间低两头高态势,极早早产儿、极低低出生体重儿比例均以40岁以上产妇比例最高,出生缺陷率随产妇年龄增加而增加。多因素分析显示,控制产妇户籍类型、产次、体质指数、小孩性别后,与20～29岁组相比,35～39岁组和≥40岁组产妇低出生体重儿和早产儿的危险性增加。结论:深圳市大样本研究表明产妇高龄与不良的妊娠结局有关。     

Efficacy and continuation rates of Norplant in Pakistan.

A total of 265 women who had the Norplant system inserted were followed for 5 years. The present study is based on 11,435 women-months of use, describing the continuation rates and efficacy of Norplant among these women. The 5-year cumulative continuation rate was 45.7 per 100 continuing users. The continuation rates were age-dependent. The women > or = 35 years of age consistently maintained higher continuation rates at all time intervals as compared with those of younger women. During 5 years of follow-up, five women became pregnant. Three pregnancies occurred in year 2, one in year 3, and one in year 5. The 5-year cumulative pregnancy rate was 2.5 per 100 continuing users. The weight of the user did not influence the pregnancy rate. The continuation rates, as well as the pregnancy rates, are comparable to those reported from other countries in the region.     

Estimates of pregnancies and pregnancy rates for the United States, 1976-85.

After increasing by 9 per cent in the period 1976-80 in the United States, pregnancy rates declined by 4 per cent between 1980 and 1984 (from 111.9 to 107.3 pregnancies per 1,000 women aged 15-44 years). Between 1984 and 1985, the rate rose by less than 1 per cent to 108.2. More detailed data by age and race, available only through 1983, indicate that the decline in the 1980-83 period was not shared by all age groups. For example, pregnancy rates continued to increase for women in their thirties, and teenage pregnancy remained substantially the same. In 1983, 61 per cent of all pregnancies ended in live birth, 26 per cent in induced abortion, and 13 per cent in fetal loss. Pregnancy rates in that year were two-thirds higher for women of races other than White than for White women, and pregnancies of other-than-White women were more likely to terminate as an induced abortion or fetal loss. However, White teenagers and teenagers of other races were about equally likely to have their pregnancy end in induced abortion or fetal loss.     

3种宫内节育器避孕效果比较性研究

目的 :比较曼月乐、吉妮与 MCu宫内节育器 IUD的避孕效果。方法 :将 2 50例妇女分成 3组 ,分别放置曼月乐、吉妮与 MCu,随访 12个月 ,对其避孕效果、副反应和续用率进行观察对比。结果 :3种宫内节育器的妊娠率均在低水平 ,相比无显著差异 (P>0 .0 5)。脱落率每百例妇女分别为 1.59、 0 .91和 4.73 ,曼月乐与吉妮组比较差异不显著 (P>0 .0 5) ,与 MCu组相比差异显著 (分别为 P<0 .0 1,P<0 .0 1) ;出血率每百妇女分别为 0 .81、 1.61和 7.80 ,曼月乐组最低 ,与其它两组相比差异显著(P<0 .0 5) ;续用率每百妇女分别为 94.95、 93 .3 6和 85.71,曼月乐组最高 ,与吉妮组比较无显著差异 (P>0 .0 5) ,与 MCu组相比差异显著 (P<0 .0 1)。结论 :曼月乐是 3种 ICU中副反应较小 ,脱落率低且避孕效果较理想的一种。     

新疆阿勒泰市哈萨克族5~7岁儿童身体成分状况分析

目的 了解阿勒泰市哈萨克族5~7岁儿童的身体成分状况,为这一少数民族群体的健康发育提供数据基础。方法 采用随机整群抽样的方法在阿勒泰市随机抽取1004名5~7岁哈萨克族儿童进行身体成分的测试,并对结果进行分析。结果 阿勒泰市5~7岁哈萨克族儿童超重率为4.18%,肥胖率为2.29%。男女生BMI值在7岁年龄段存在统计学意义（T=2.606,P＜0.05）。男生和女生上下肢肌肉量和躯干及肌肉总量随着年龄的增长而不断增加。5岁年龄段男女生右下肢、躯干部位的肌肉重量存在统计学意义（T=3.878、2.49,P＜0.05）;男女生6岁年龄段右上肢肌重量也存在差异（T=-2.751,P＜0.05）;男女生在7岁年龄段,四肢和躯干肌重量及肌肉总重量均存在统计学意义（T=1.996、5.025、2.272、5.048、2.506、3.671,P＜0.05）。6岁年龄段女生的骨量高于男生（T=-3.944,P＜0.05）。7岁年龄段男女生在去脂体重、蛋白质总量方面存在统计学意义（T=2.782、4.835,P＜0.05）。结论 阿勒泰市5~7岁哈萨克族不同性别儿童身体成分随着年龄的变化而不断变化,应将年龄和性别作为这一群体营养和健康研究的重要因素予以考虑。     

Prolonged effectiveness of Norplant(R) capsule implants: a 7-year study

Soft tubing Norplant(R) contraceptive implants were studied in 1210 women for 7 years to measure the duration of effectiveness and the magnitude of the pregnancy rates over that time. Mean age at enrollment was 27.4 years. Of the enrollees, 42% were US residents. One-sixth (16.1%) weighed >/=70 kg at the time of implant placement. At the end of 5 years, the cumulative pregnancy rate was 1.1/100; at the end of 7 years, it was 1.9/100. No pregnancies occurred to any of the 400 women who enrolled in the study at age >/=30 years and who weighed <100 kg. Among women aged 18-33 years, the 7-year Norplant pregnancy rates are comparable to the median pregnancy rates of tubal sterilization methods for women of the same age and duration of use. For women aged >/=34 years, without regard to weight at admission, the 7-year effectiveness of soft tubing Norplant equals or surpasses that of tubal sterilization. For continuing implant users, annual pregnancy rates <1.0/100 in years 6 and 7, together with low cumulative pregnancy rates, testify that Norplant capsule implants remain highly effective for 7 years.     

Weight loss: a determinant of hip bone loss in older men and women. The Rancho Bernardo Study

The sex-specific effect of weight change on change in total hip bone mineral density was evaluated over 4 years (1992-1996) in 1,214 community-dwelling adults whose mean age at baseline was 71 years. Weight and bone mineral density (by dual-energy x-ray absorptiometry) were assessed at two study visits. The average bone loss was 0.5% per year in both sexes; 29% of men and 28% of women lost at least 1% of bone mineral density per year. More than one in five participants lost at least 1% of their body weight per year (21% of men and 23% of women). These weight losers were twice as likely as others to lose bone at the rate of at least 1% per year. In analyses controlling for age, baseline weight, and lifestyle, weight loss was the strongest independent predictor of bone loss (odds ratios were 1.53 for men and 1.56 for women). Persons with weight loss of at least 1% per year were more likely to report fair or poor health and functional limitation at the second visit and to die within 2 years of the second visit; however, most did not report declining health, and most survived for at least 2 additional years.