育龄妇女宫内节育器位置下移影响因素分析

目的:观察使用IUD避孕的育龄妇女中各类不同因素对IUD下移程度的影响并分析IUD发生下移的主要危险因素和降低风险的主要措施。方法:对使用IUD避孕的108例妇女采用结构式问卷进行访谈并行妇科及B超检查,测定IUD上缘到子宫底外缘的距离以>20 mm者确定为IUD下移,记录相关因素数据。结果:B超诊断15例IUD下移,下移率为13.89%,痛经、妊娠次数、上取环次数、置环后不良反应为IUD下移的危险因素;妇科炎症经有效治疗、置环后合理用药为保护性因素;后位子宫、产后哺乳期放置IUD、基层计生站放置IUD下移发生率低。结论:放置IUD术前认真询问病史、做好妇科体检、治疗痛经及妇科炎症,术后合理用药、减少不良反应,可使IUD下移的危险性降低;基层计生服务放置IUD质量较好,应重视和加强以便更好高效地为育龄妇女服务。

Analysis on influencing factors of downward dislocation of intrauterine device in women of childbearing age

Objective:To observe the effect of various factors on degree of downward dislocation of intrauterine device(IUD) in women of childbearing age,and analyze the main risk factors of downward dislocation of IUD and main measures to reduce the risk.Methods:One hundred and eight women using IUD for contraception received interview via a structural questionnaire,gynecological examination and ultrasonography were performed;the distance between superior border of IUD and outer edge of fundus of uterus more than 20 mm was designed as downward dislocation of IUD;the related factors were recorded.Results:Fifteen women were diagnosed as downward dislocation of IUD by type-B ultrasound,the incidence rate was 13.89%.The risk factors of downward dislocation of IUD included dysmenorrhea,gravidity,times of IUD usage,and adverse reactions after IUD usage;the protective factors included gynecological inflammation after effective treatment and reasonable drug use after IUD usage;the incidence rates of downward dislocation of IUD were low in women with posterial uterus,inserting IUD during lactation period and at primary family planning service stations.Conclusion:The measures to reduce the risk of downward dislocation of IUD include inquiring medical history seriously,conducting gynecological examination,curing dysmenorrhea and gynecological inflammation before inserting IUD,drug use reasonably and reducing adverse reactions after inserting IUD;the quality of inserting IUD in primary family planning service stations is good,which should be paid more attention to and strengthened to offer service for women of childbearing age more efficiently.