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1.
活性γCu380IUD与TCu380AIUD临床比较性研究   总被引:1,自引:0,他引:1  
本研究通过增加原γCu 2 0 0 IUD的铜表面积至 3 80 mm2 ,其目的为了进一步降低带器妊娠率 (包括异位妊娠 ) ,以期达到 TCu3 80 A IUD相似的避孕效果 ,而其副反应发生率明显低于 TCu3 80 A IUD。方法 :1 995年 8月~ 1 996年 6月由三个中心参加的随机比较性研究 ,共随访 2 4个月。每个中心分别放置γCu 3 80与 TCu 3 80 A IUD各 1 0 0例 ,共 6 0 0例。结果 :2 4个月末 γCu3 80与 TCu3 80 A IUD脱落率每百妇女分别为 0 .997和 2 .4 70 (P>0 .0 5)。带器妊娠率每百妇女分别为 0 .3 3 2和 2 .4 59(P<0 .0 5)。异位妊娠率每百妇女分别为 0 .1 6 1和 0 .3 3 0 (P>0 .0 5)。因症取出率每百妇女分别为 1 .6 6 1和 5.4 95(P<0 .0 5)。结论 :γCu 3 80 IUD临床避孕效果明显优于 TCu 3 80 A IUD;两种 IUD的异位妊娠率相似 ;γCu3 80 IUD的副反应发生率明显低于 TCu3 80 A IUD。本研究结果证实高铜面积 γCu3 80 IUD是一种优质的 IUD。  相似文献   

2.
活性γCu380 IUD与TCu380A IUD多中心比较性研究   总被引:5,自引:0,他引:5  
本研究通过增加原γCu2 0 0 IUD的铜表面积至 380 mm2 ,以期在不增加副反应的基础上进一步降低带器妊娠率 (包括异位妊娠 ) ,而达到与 TCu380 A IUD相似的避孕效果 ,并保持原来的低副反应发生率。方法 :1 998年 1~ 5月由全国五个中心参加的随机比较性研究 ,共随访 1 2个月。每个中心分别放置γCu380与 TCu380 A IUD各 1 0 0例 ,共 1 0 0 0例。结果 :1 2个月末 γCu380与 TCu380 A IUD脱落率每百妇女分别为 0 .80和 1 .99(P>0 .0 5)。带器妊娠率每百妇女均为 0 .2 0。异位妊娠率每百妇女分别为 0 .2 0和 0 .0 0 (P>0 .0 5)。因症取出率每百妇女分别为 1 .0 0和 2 .6 0 (P>0 .0 5)。结论 :γCu380 IUD临床效果与 TCu380 A IUD相似 ,而 γCu380 IUD副反应发生率明显低于 TCu380 A IUD。本研究结果证实载高铜面积 γCu380 IUD是一种优质的 IUD。  相似文献   

3.
置入新型MCu功能性宫内节育器1050例24个月临床报告   总被引:6,自引:0,他引:6  
目的 :为了研究新型MCu功能性宫内节育器 (MCu IUD)的安全性、可接受性及临床效果。方法 :由 4个临床中心共放置MCu IUD10 5 0例 ,并随机抽样MCu IUD与TCu2 2 0C IUD各 10 9例 ,作临床效果对比观察。结果 :放置满 2 4个月时 ,随访率 >95 %。 10 5 0例使用MCu IUD者 2 4个月带器妊娠率为 0 2 9% ,脱落率为 0 ,续用率为 92 6 7%。放置MCu IUD与TCu2 2 0C IUD各 10 9例 ,观察 2 4个月 ,续用率分别为 93 5 8%和 81 6 5 % ;两组累积妊娠率分别为 0 92 %和2 75 % ;两组累积脱落率各为 0和 2 75 % ;两组因症取出率分别为 2 75 %和 9 17% ,差异均有显著性 ,P均 <0 0 5。副反应发生率MCu IUD组少于TCu2 2 0C IUD组 ,12个月时P <0 0 1,差异有非常显著性 ;2 4个月时差异无显著性。结论 :MCu IUD置、取方便 ,具有抗生育效果好、脱落率低、带器妊娠率低、副反应少、安全等特点 ,是当前应用效果比较理想的IUD。  相似文献   

4.
目的:探讨宫腔镜下子宫中隔切除(transcervical resection of septum,TCRS)术后预防宫腔粘连形成及改善妊娠结局的最佳治疗方案。方法:TCRS术后患者116例随机分为4组:A组(n=30),术后行人工周期;B组(n=31),术后宫腔放置宫内节育器(IUD);C组(n=27),术后放置IUD+行人工周期;D组(n=28),术后不采取任何干预措施。术后3个月再次行宫腔镜检查,观察宫腔是否发生粘连及粘连分布,随访至术后24个月,记录月经恢复情况及妊娠结局。结果:A组排除9例(6例失访,3例漏服药物),B组排除6例(4例失访,2例IUD脱落),C组排除2例(1例失访,1例IUD下移),D组排除5例(均为失访)。4组术后3个月宫腔粘连发生率依次为:14.2%(1/7)、37.5%(3/8)、22.2%(2/9)、9.1%(1/11);随访至术后24个月,妊娠率分别为:33.3%(7/21)、32.0%(8/25)、36.0%(9/25)、47.8%(11/23);流产率分别为:4.8%(1/21)、12.0%(3/25)、8.0%(2/25)、4.3%(1/23),宫腔粘连发生率、妊娠率和流产率组间均无统计学差异(P>0.05)。结论:TCRS术后进行人工周期、IUD、IUD+人工周期3种治疗方法对防止宫腔粘连形成及提高妊娠率、改善妊娠结局方面无明显益处,且治疗效果差别不大,术后不必将其作为常规治疗方法。  相似文献   

5.
吉妮固定式宫内节育器应用效果的研究   总被引:7,自引:0,他引:7  
目的 :研究吉妮固定式宫内节育器 (GyneFixIUD)的效果。方法 :对 10 7例放置GyneFixIUD和 80例放置含铜 375IUD的妇女进行 1年的临床观察和对照研究。结果 :(1)Gyne组在去除放置技术或子宫过软所致的脱落因素后 ,脱落率显著低于含铜组 (P <0 .0 5) ;(2 )在放置IUD后 3个月和 6个月时 ,副作用有淋漓出血 ,经量过多和白带增多等 ,Gyne组明显低于含铜组 ,差异有显著性 (P <0 .0 1,P <0 .0 5,P <0 .0 1)。结论 :GyneFixIUD的临床使用效果好于含铜 375IUD ,脱落率和副作用低于含铜 375IUD  相似文献   

6.
目的 了解3种常用宫内节育器(IUD)在人工流产术后即时放置的临床效果和安全性.方法 通过前瞻性随机对照临床研究,对来自全国7个省市的12个协作中心的1800例研究对象于人工流产术后即时放置IUD,放置的IUD类型分为宫形含铜IUD宫铜200、T形含铜IUDTCu380A和活性γ型IUD 3种,每种分别观察600例,并随访12个月.结果 1798例完成了使用12个月的随访,2例失访(失访率为0.11%,2/1800);17例不符合纳入标准的未产妇资料在进行数据统计分析时被剔除.3种IUD使用者均未发生妊娠(或带器妊娠),且均无子宫穿孔、IUD异位等并发症发生.活性γ型IUD的医疗原因终止率为1.02/百妇女年,低于宫铜200、TCu380A(分别为3.60/百妇女年、2.25/百妇女年),3者比较,差异有统计学意义(P=0.015).宫铜200、TCu380A和活性.y型IUD中,与IUD使用相关的终止率分别为7.58/百妇女年、7.30/百妇女年和3.72/百妇女年,3者比较,差异有统计学意义(P=0.008).结论 人工流产术后即时放置宫铜200、TCu380A和活性γ型IUD的避孕效果均良好,均安全可行,尤其是国产活性γ型IUD,值得推广.  相似文献   

7.
目的:了解围绝经期及绝经后妇女宫内节育器(IUD)的取出情况及实际使用年限。方法:以在黄浦区居住且末次使用避孕方法为IUD的45~60岁妇女为研究对象,于2011.08~12期间开展横断面调查,共调查2 167人,其中2 054人纳入分析。结果:研究对象平均年龄52.4±4.0岁。1 160例已绝经的妇女中,63例(5.4%)使用的IUD仍未取出,其中15例IUD已放置至绝经后5年以上;IUD的平均宫内放置时间为18.9±5.7年,50.2%的IUD使用者宫内放置时间20年。732例未绝经的妇女中,IUD的平均使用年限为17.3±5.7年,有51.1%的女性使用IUD已超出建议使用期限。结论:绝经后IUD过期使用情况严重,相当一部分正在使用的IUD已超过了使用期限。  相似文献   

8.
目的:分析胚胎移植技术与体外受精后临床妊娠、种植率和继续妊娠率之间的关系。方法:回顾性分析653例新鲜胚胎移植,比较移植情况和临床结果之间的关系。结果:腹部超声引导下胚胎移植后临床妊娠率为47.3%,种植率25.0%,继续妊娠39.7%。移植管顶端位于宫内不同位置以及血染情况不影响结果。8.8%困难移植明显降低种植率(20%比26%),临床妊娠率也降低(35.8%比48.3%),但无统计学差异。结论:腹部超声引导下胚胎移植可以达到较好的临床结果。胚胎放置在宫腔内不同位置以及移植管血染不影响临床结果,但要尽量避免困难移植.  相似文献   

9.
目的 :了解第二代吲哚美辛 VCu IUD的临床疗效。方法 :自 1 997.5~ 1 998.2 ,在包括城市和农村的 6个临床单位 ,放置第二代吲哚美辛 VCu IUD1 0 0 0 (V组 )例 ;放置后 6月、1 2月和 2 4月随访 ,并与 1 0 0 0例放置 TCu3 80 A IUD者 (T组 )比较。结果 :两组对象临床特征相仿。随访率 98.2 5 %。净累积续用率随访 6月时 T组 95 .5 % ,V组 97.5 % (P<0 .0 5 ) ;1 2月时分别为 93 .79%和94.78% ;2 4月时分别为 88.2 3 %和 89.77%。脱落率在各阶段均为 T组高于 V组。妊娠率和因出血、疼痛取出率两组基本相似。月经量多、经期延长和腹痛的发生率 T组始终高于 V组。点滴出血者在 1 2月内 T组多于 V组。 V组月经量减少者始终多于 T组。在置器 4~ 6月 ,T组总 B/S、平均B/S及最大 B/S段长均大于 V组 (P<0 .0 1 )。血红蛋白测定在放 IUD前两组相似 ,随访 2 4月时复查 ,T组较放置前有所下降 (P<0 .0 0 1 ) ,且低于 V组 (P<0 .0 0 1 ) ;V组与放置前相似。结论 :第二代吲哚美辛 VCu与 TCu3 80 A比较 ,具有相同的避孕效果及续用率 ,较低的出血、疼痛副反应 ,更有利于保护妇女的生殖健康 ,值得临床推广应用  相似文献   

10.
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(P0.05);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(P0.05),其中吉妮致美和活性γ组出血时间短于TCu组和LNG-IUS组(P0.05);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(P0.05),其中LNG-IUS组痛经改善好于其他各组(P0.05)。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。  相似文献   

11.
The study objective was to examine the cervical flora during the insertion of an IUD and to determine whether the presence of the device in utero modified this flora. A secondary objective was to determine whether the colonization of the cervix with (occasionally) pathogenic bacteria warrants a prophylactic antibiotic treatment. IUDs were inserted in a group of 20 women, ranging in age from 23-40 years, at the Family Planning Clinic of Meir Hospital in Kfar Saba, Israel. The cervical bacterial flora was examined during insertion and again after a period of 3-12 months with the IUD in situ. None of the women received antibiotic or antifungal treatment for 3 months prior to or 12 months after insertion. The women were divided into 2 groups according to the type of IUD used. Group A consisted of 22 women with nonmedicated IUDs and Group B included 28 women with IUDs medicated with copper. A cervical swab was collected during insertion of the IUD and at 3-12 months afterwards. Of the 50 cervical cultures collected during the insertion, 48 (84%) were sterile, but only 27 of the cultures collected after 3-12 months with the IUD in utero were sterile. The medicated IUD had a more intense bacteriostatic effect on the bacterial cervical flora than the other devices. Among the copper IUDs the best results were obtained with the Nova T type and secondly with the Copper 7 (Gravigard). It is possible that the pathogenic organisms enter the uterine cavity and tubes from the cervix during insertion of the IUD. It may be concluded that during IUD insertion prophylactic treatment with a broad spectrum antibiotic would be indicated, but the study showed that this was not the case. The organisms isolated in the women studied were those normally found in the upper vagina and cervix and only occasionally became pathogenic. Medicated IUDs are preferable because of the bacteriostatic activity of the copper and to the fact that they are normally left in utero for a shorter time than the unmedicated IUDs.  相似文献   

12.
OBJECTIVE: To model rates of pregnancy and repeat abortion among women choosing intrauterine contraception after an abortion when the intrauterine device (IUD) is inserted immediately after the procedure or at a follow-up visit. METHODS: We created an evidence-based decision model of women desiring to avoid pregnancy for the 12 months after an abortion. Base case assumptions were pregnancy rates of 0.5% with an IUD and 20% without an IUD, 1-year IUD continuation rate of 80%, an additional 5% risk of IUD expulsion with immediate insertion, and a 35% risk of not returning for a follow-up visit for IUD insertion. Sensitivity analyses and Monte Carlo simulation were performed. RESULTS: Immediate IUD insertion after abortion prevented 52 pregnancies over the following year for every 1,000 women modeled by using base case assumptions. Sensitivity analyses show the model to be most dependent on the rate of expulsion in the immediate-insertion group and the proportion not returning in the delayed-insertion group. Monte Carlo analysis showed that immediate insertion resulted in fewer pregnancies than delayed insertion in 91% of scenarios, with an absolute mean difference of 28 pregnancies per 1,000 women in the initial year after abortion. If 20% of U.S. women undergoing abortion opted for immediate insertion, an estimated 20,000 repeat abortions would be prevented in the first year. CONCLUSION: Women who have an IUD inserted immediately after an abortion are expected to have fewer pregnancies and repeat abortions than women scheduled for insertion of an IUD at a follow-up visit.  相似文献   

13.
本文观察了22例放置孕酮宫内节育器和19例放置不含孕酮的宫内节育器妇女上环前及上环后月经第一天之月经血及周围静脉血中纤溶活性、抗凝血酶Ⅲ(AT-Ⅲ)和因子Ⅷ相关抗原(ⅧR:Ag)的变化。以探讨放置孕酮宫内节育器后经血量减少的机制。结果表明:放置孕酮IUD妇女经血量减少的机制既不是AT-Ⅲ活力的变化,亦不是通过合成、释放ⅧR∶Ag的增加从而加强血小板的粘附作用。而经血中纤溶活性的降低则可能是置孕酮IUD者经血量减少的重要机制之一。  相似文献   

14.
OBJECTIVE: The contraceptive efficacy of intrauterine devices (IUD) is thought to relate to the position of the IUD in the uterine cavity. Several trials examined the number of copper IUD expulsions, but none evaluated the partial and complete expulsion rate of the levonorgestrel-releasing device (LNG-IUD). STUDY DESIGN: This retrospective cohort study compares the dislocation rate of the Multiload 375 IUD (ML 375) and the LNG-IUD in 214 women (107 subjects with each IUD). Transvaginal ultrasound was used to monitor the IUD position immediately after insertion, after 6 weeks, and later on at intervals of 6 months. The observation period included 3631 cycles. RESULTS: We detected a significantly lower number of dislocations in LNG-IUD users. Previous expulsion was associated with a significantly higher risk for a re-expulsion in both IUD groups. Hypermenorrhea was not associated with an increased dislocation rate in LNG-IUD users. CONCLUSION: Expulsions are less likely to occur with the LNG-IUD, which might contribute to its contraceptive efficacy.  相似文献   

15.
Objective: Systematic review and meta-analysis to assess the effects of uterine or paracervical lidocaine application on pain control during IUD insertion.

Methods: PubMed and five other electronic research databases were searched through 15 November 2017 for RCTs comparing lidocaine treatment vs. a control (placebo or no-intervention) to prevent pain during IUD insertion. Searched terms included ‘IUD insertion’, ‘lidocaine’ and ‘randomised controlled trial’. RCTs evaluating lidocaine treatment before IUD insertion without restriction of language, age and IUD type. Pain measured by visual pain scales at tenaculum placement, IUD insertion and immediate post-IUD insertion. Results of random effects meta-analyses were reported as mean differences (MDs) of visual pain scale (VPS) scores and their 95% confidence intervals (CIs).

Results: Eleven RCTs (n?=?1458 women) reporting paracervical lidocaine block or uterine mucosa lidocaine application before IUD insertion. Lidocaine produced lower VPS scores during tenaculum placement (MD ?0.99, 95% CI: ?1.73 to ?0.26), IUD insertion (MD ?1.26, 95% CI: ?2.23 to ?0.29) and immediate post-IUD insertion period (MD ?1.25, 95% CI: ?2.17 to ?0.33).

Conclusion: Lidocaine treatment was associated with modest reduction of pain during tenaculum placement and after IUD insertion.  相似文献   

16.
Study ObjectiveTo describe the bleeding patterns associated with the use of the levonorgestrel intrauterine device (IUD) in adolescents.Design, Setting, and ParticipantsA retrospective chart review of postmenarchal adolescent patients ages 8-19 years who had the levonorgestrel IUD inserted at Phoenix Children's Hospital from 2012 to 2018.InterventionsInsertion of the 52-mg and 13.5-mg levonorgestrel IUD.Main Outcome MeasuresThe rate of amenorrhea and other bleeding patterns after insertion of the levonorgestrel IUD and the factors that might predict those bleeding patterns.ResultsA total of 260 charts were identified with 221/260 (85.0%) patients choosing the 52-mg IUD and 39/260 (15.0%) patients choosing the 13.5-mg IUD to be inserted. Follow-up data were available for 166 patients. The overall rate of amenorrhea among IUD users was 39.8% (n = 66) with no difference between 52-mg and 13.5-mg IUD users (P = .656). Regularity and flow of menstrual cycle, history of bleeding disorder, history of developmental delay, and current treatment with testosterone for gender dysphoria before IUD insertion did not appear to have a significant effect on the rate of amenorrhea or bleeding patterns post-IUD insertion.ConclusionThe levonorgestrel IUD can be successfully used to control abnormal uterine bleeding and suppress menses in adolescents. Menstrual cycle characteristics pre-IUD insertion did not result in predictable post-IUD bleeding patterns.  相似文献   

17.

Background

Immediate postsurgical abortion insertion of intrauterine devices (IUDs) could substantially reduce the risk of repeat abortion. Studies have demonstrated efficacy and safety, and postabortum insertion would likely increase rates of usage. There are few data in the literature concerning rates of continuation and satisfaction after immediate postabortion IUD insertion.

Study design

We performed a prospective cohort study of women undergoing surgical abortion and choosing immediate insertion of IUD for contraception. We followed at six months rates of continuation, expulsion, removal and pregnancy, and reasons for discontinuation of IUD postinsertion.

Results

137 patients were included. At 6 months, we were able to contact 112 of them. The continuation rate was 78.6% (95% confidence intervals (CI) [69.8, 85.8]) and the satisfaction rate was high at 85.2% (95%CI [76.1, 91.1]). Three (2.7%) expulsions occurred. Removals occurred in 18.75%.

Conclusions

We found that women choosing immediate postsurgical abortion IUD insertion had high rates of continuation and satisfaction.  相似文献   

18.
Aim of study: To reduce the pain and duration of the intrauterine device (IUD) insertion procedure through minimizing instrumentation and using trans-abdominal sonography (TAS).

Methods: This randomized control trial was conducted in a university hospital and included 102 eligible females, fulfilling the inclusion criteria. They were randomly assigned into two groups via 1:1 computer-based randomization program; the trans-abdominal guided IUD insertion group (n?=?51), and the traditional IUD insertion group (n?=?51). The main outcomes were the pain experienced during the procedure as scored by the visual analogue score and the duration of the procedure.

Results: The trans-abdominal guided IUD insertion was found to be statistically superior to the traditional technique for IUD insertion regarding the pain scores (according to the Visual Analogue Scale, from 0 to 10) recorded by the candidates (2.4?±?2.1 vs. 5.0?±?1.7, p?p?Conclusions: Due to the decrease in pain and time taken for IUD insertion, the trans-abdominal guided technique can be used as a modified technique for IUD insertion.

ClinicalTrials.gov Identifier: NCT02582268.  相似文献   

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