放置不锈钢IUD20年以上妇女的长期安全性研究——临床与病理分析

调查了上海市所属崇明、嘉定二个县及川沙县三个公社的全部放置了不锈钢宫内节育环20年以上妇女635人的临床情况;调查了上述地区年龄相似未放环的妇女724例作为对照。临床症状发生率经年龄与绝经年龄配对后,放环组中赤带的发生率增高4.87%(P<0.05),而月经量增多与不规则出血的发生率增高极少(P>0.05)。放环组取环374例其宫腔括出物中均未见癌,特别注意了内膜的直接压迫与移行区内膜亦未见明显间变。子宫内膜轻度增生过长9例,占2.41%。与放置时间长短无关。其中315例较完整的内膜中,有炎症者32例,占10.15%。其发生率与环的放置时间长短无关。内膜炎中3例为放线菌感染。374例取环困难情况与环的放置时间长短无明显关系,而与绝经年限长短有关,随着绝经年限增长而困难增多。23例宫腔X 线造影发现宫腔随着绝经年限增长而逐渐缩小,环的嵌顿越来越深。

THE LONG TERM SAFETY USE OF THE STAINLESS STEEL UID OVER 20 YEARS-Clinical and Pathological Analysis

635 women with stainless steel ring retained in uterus for 20 years or more and 724women of similar age without IUD as controls were under investigation.Comparison of incidences of clinical symptoms of paired wearers and controls by agein pre-menopausal women and by post-menopausal duration in post-menopausal womenshowed that the tinged vaginal discharge in the study group was 4.87% higher than the control(P<0.05).There was no difference in menorrhagia,irregular bleeding or other maineffects.No.cancerous change was found in the uterine curettage specimens of 374 IUD usersin the study group.Special attention was paid to the epithelium at the site in contact with theIUD and its adjacent areas showed no apparent dysplasia.There were 9 cases(2.41%)with mild hyperplasia of endometrium.The incidence had no correlation with the prolonga-tion of insertion duration.Among the 315 relatively intact endometrium specimens,therewere 32 cases of inflammation(10.15%).The incidence had no correlation with duration.Three endometritis cases were actinomyces infection.Among 374 removals,the removal difficulties did not apparently relate with their IUDinsertion duration but did correlate to duration of menopause.Hysterograms of 23 casesshowed that atrophy of uterine cavities progressed with the increase of menopausal years,the longer the duration the deeper incarceration of the IUD.