母体乐宫内节育器用于紧急避孕观察

目的探讨母体乐宫内节育器（IUD）用于紧急避孕的临床效果及随访24个月IUD带器妊娠率、脱落率、续用率及不良反应。方法自2005年5月至2009年6月来我院寻求紧急避孕（EC）育龄妇女546例中筛选出距第一次无保护性生活72～120h之间就诊者162例;由专人放置母体乐IUD,并对需求长期避孕134例中130例进行正规随访1、3、6、12、24个月。结果 162例受试者避孕有效率97.48%。随访24个月妊娠率、脱落率分别为0.76%、1.54%,续用率86.92%。结论母体乐IUD用于紧急避孕是高效安全的,且尤其适用于要求长期避孕者。     

活性元宫型宫内节育器用于紧急避孕观察

目的探讨活性元宫型宫内节育器(IUD)用于紧急避孕的临床效果及随访24个月IUD带器妊娠率、脱落率、续用率及不良反应。方法选自2002年5月—2006年6月来濮阳市妇幼保健院寻求紧急避孕(EC)育龄妇女872例中筛选出距第一次无保护性生活72～120h之间就诊者324例;由专人放置活性元宫型IUD,并对需求长期避孕268例中260例进行正规随访1、3、6、12、24个月。结果324例受试者避孕有效率97.48%。随访24个月妊娠率、脱落率分别为0.38%、1.54%,续用率86.92%。结论活性元宫型IUD用于紧急避孕是高效安全的,且尤其适用于要求长期避孕者。     

3种宫内节育器使用1年的避孕效果对比

目的比较元宫(I-220)药铜、T型(TCU220普通型)和吉妮3种宫内节育器的避孕效果。方法将自愿要求放置宫内节育器避孕而无禁忌证的育龄妇女286例,随机分成3组,分别放置元宫药铜宫内节育器100例,T型宫内节育器100例,吉妮宫内节育器86例。于放置后1、3、6、12个月进行随访。结果 3种宫内节育器使用1年后的带器妊娠率、脱落率、因症取出率、续用率分别为:元宫药铜组1.0%、3.0%、4.0%、92%;T型组2.0%、3.0%、7.0%、88%;吉妮组1.16%、1.16%、1.16%、96.52%。3种宫内节育器的带器妊娠率差异无统计学意义,3种节育器均具有较好的避孕效果。元宫药铜和吉妮宫内节育器具有脱落率低、因症取出率低、续用率高等优点,有临床使用价值。     

B超监测人工流产术即时放置宫内节育器122例

目的观察B超监测人工流产术即时放置吉妮柔适宫内节育器（GyneFix IN／S型，简称IN IUD）的临床效果。方法对确诊宫内孕5—10周，要求终止妊娠且同时需避孕的妇女122例，在B超监测下施行人工流产术后即时放置IN IUD，术后定期随访。结果本组122例均一次放置成功。在随访中使用者无感染、带器妊娠、脱落及因症取出，续用率达100％。有5例患者发生点滴出血或分泌物带血呈暗红色，经治疗后正常。结论在B超监测下人工流产术后即时放置IN IUD，避孕率高，脱落率低，续用率高，是安全有效的宫内节育器，值得临床推广。     

吉妮节育器与T型节育器的应用效果对比观察

目的探究吉妮节育器与T型节育器的避孕应用效果对比观察。方法对照组放置TCU220C节育器,观察组放置吉妮节育器,随访12个月,观察对比两组避孕效果及不良反应情况。结果两组均一次性成功放置,随访12个月后,观察组续用率为98.16%,明显高于对照组的84.25%,P<0.05。观察组不良反应发生率为6.68%,明显低于对照组的17.76%,组间比较差异具有统计学意义,P<0.05。结论吉妮式宫内节育器固定更为牢固,从而可提高避孕有效率,且对宫腔机械刺激更小,可有效降低术后不良反应。     

人工流产术后即时放置吉妮致美宫内节育器的的临床观察

目的探讨人工流产术后即时放置吉妮致美宫内节育器的临床效果及不良反应。方法将人工流产术后即时放置宫内节育器的患者106例随机分为两组,分别为观察组(吉妮致美)44例、对照组(母体乐)62例,门诊随访1年,观察两组的不良反应和临床效果。结果临床效果的观察中,观察组的因症取出率(4.5%)较对照组(17.7%)低,而续用率(93.2%)较对照组(77.4%)高,两者比较P<0.05,差异有统计学意义;不良反应的观察中,观察组月经异常的发生率(4.5%)明显低于对照组(19.4%)(P<0.05),差异有统计学意义。结论人工流产术后即时放置吉妮致美宫内节育器因症取出率低,续用率高,对月经的稳定性干扰小,值得临床进一步推广应用。     

Mcu IUD与宫腔形宫内节育器的临床效果观察

目的:观察Mcu IUD的临床效果.方法:将自愿要求放置宫内节育器(IUD)避孕的育龄妇女随机分为观察组140例和对照组140例,观察组放置Mcu IUD,对照组放置宫腔形IUD.结果:观察组带器妊娠率、脱落率、不良反应发生率明显低于对照组,续用率明显高于对照组.结论:Mcu IUD是一种新型宫内节育器,具有放置时疼痛轻、带器妊娠率低、脱落率低、不良反应发生率低和续用率高等优点,值得临床推广应用.     

放置MYCu宫内节育器150例临床观察

目的 观察新型MYCu宫内节育器(MYCuIUD)的临床效果.方法 在我院计划生育门诊选择无手术禁忌证,自愿要求放置MYCuIUD避孕者150例,常规放置MYCuIUD,于术后1、3、6、12个月进行随访.结果 放置后12个月累积带器妊娠率为0.67%,累积脱落率为0,累积因症取出率为0.67%;术后1个月月经异常发生率为10%,随访到12个月时降低至0.68%.结论 MYCuIUD使用简便,带器妊娠率低,脱落率低,因症取出率低,续用率高,且适应证广泛,可满足广大要求放置IUD避孕的育龄妇女需求,值得临床广泛推广使用.     

活性γ型宫内节育器与传统宫内节育器应甩效果比较

目的分别比较活性γ型宫内节育器（安舒环）与传统宫内节育器（元官环及T型环）的临床使用效果。方法对来我院自愿要求放置宫内节育器避孕而无禁忌证的育龄妇女629例，根据她们自愿放置宫内节育器的种类分成三组，即安舒环组、元宫环组、T型环组，分别进行为期1年的随访观察，比较三组宫内节育器置入后的不良反应、异位发生情况、带环受孕及脱落情况、续用率等。结果安舒环使用1年的不良反应发生率低，续用率高，与传统宫内节育器相比，差异有统计学意义。在异位、带器妊娠、脱落情况上，安舒环与元宫环相比差异无统计学意义，与T型环相比差异有统计学意义。结论安舒环与传统官内节育器相比具有不良反应少、续用率高等优点。     

吉妮系列宫内节育器临床效果观察

目的 观察吉妮系列宫内节育器(IUD)临床效果.方法 放置吉妮系列IUD446例(吉妮致美IUD116例,吉妮柔适IUD210例,吉妮IUD120例),临床观察使用24个月的脱落率、妊娠率、因症取出率及续用率,并与使用母体乐118例病例进行比较.结果 置器后24个月,吉妮系列IUD脱落率明显低于母体乐,差异有显著意义(...     

流产后避孕措施指导和随访的探讨研究

目的 研究探讨建立一种对避孕措施的指导和随访模式,提高避孕措施尤其短效避孕措施的正确使用率,降低非意愿妊娠的发生.方法 在门诊要求人工流产并于术后2年需要避孕的服务对象102例.在术前准备时,对服务对象做好咨询服务、生殖健康教育与避孕方法指导和选择,并进行密切随访服务.结果 人工流产即时放置宫内节育器（IUD）16例,术后半年IUD下移取出术后改用避孕套1例,采用短效避孕措施86例,术后6月内放置IUD6例.除1例失访外,均未出现非意愿妊娠.结论 对流产后的服务对象重在时机,开展避孕方法的知情选择,及时落实长效或短效避孕措施,并进行密切规范的随访服务,从而提高服务对象避孕知识知晓率,达到提高避孕有效率,降低非意愿妊娠的发生.     

Emergency contraception: knowledge and practice of Gondar University students, northwest Ethiopia

OBJECTIVES: To assess the knowledge and practice of Gondar University students regarding emergency contraceplion. PATIENTS AND METHODS: A university based cross-sectional study was conducted in the University of Gondar in May 2004. All undergraduate students of the university were included in the study. A self-administered anonymous questionnaire was used for data collection. RESULTS: A total of 2323 students (1764 males & 559 females) responded to the questionnaire. Five hundred fifty eight students (24.0%) thought that there are methods that can be used to prevent pregnancy when a woman had unprotected sex. Overall, 437 students (18.8%) knew the correct methods of emergency contraception (pill or IUCD). Of those who mentioned pill as the only method of emergency contraception, 285 (73.3%) said the pill should be used within 72 hours after unprotected sex. Only one student used pill as emergency contraceptive. Students in the health field have 6.8 times higher knowledge on emergency contraception compared to students of FBE. Generally, there was an increasing trend in the knowledge of students when their age and year of study increases. Married or divorced students had 3.36 times higher knowledge when compared with never married students. CONCLUSION: In general, except students in the health field, other students have low awareness about emergency contraception. Emergency contraceptive user rate is very low. Even in those who are aware of emergency contraception, the information they have regarding the methods that can be used and the timing of emergency contraception was not sufficient. Students should be provided with appropriate information regarding emergency contraception and access to emergency contraception should be improved in the university.     

Intrauterine contraception

Intrauterine contraceptives are widely used all over the world. They have attained 98% effectiveness. More than 50 types of IUDs of various shapes and designs have been developed, including coils, loops, and rings. Further research and development focuses on the application of IUDs containing various medicinal agents. The precise mechanism of intrauterine contraception has not been established, although numerous researchers have addressed this fundamental problem. Several hypothetical mechanisms are analyzed to conclude that IUDs produce a local contraceptive effect. An IUD is usually inserted on the 4th-6th day of the menstrual cycle and lasts for 3-4 years. Women using IUDs should undergo regular gynecological examinations. The most frequent complications of IUDs are cyclic or acyclic uterine bleeding; the occurrence of these complications may well exceed 10%. The contraceptive effect is reversible; after the IUD is extracted, women can become pregnant. As with any other contraceptive method, IUDs come with some unconditional and conditional contraindications. However, clinical observations indicate that intrauterine contraception is an effective and relatively safe method of preventing unwanted pregnancy.     

不同剂量米非司酮用于紧急避孕的结果分析

目的观察米非司酮两种剂量用于紧急避孕的临床效果。方法 120例受试者按米非司酮剂量不同,分为米非司酮25mg(A组)60例和米非司酮10mg(B组)60例,观察服药后的不良反应及月经情况、阴道流血情况等。结果 A、B组避孕成功率分别为86.6%和88.3%,组间比较无显着性差异(χ2=2.75,P>0.05);A、B组月经趋于正常者分别为63.3%和61.6%(χ2=2.99,P>0.05);A、B组不良反应11例(18.3%)和B组9例(15.0%)(χ2=2.35,P>0.05)。结论两组在避孕效果、不良反应及月经变化等方面均无明显差异,低剂量米非司酮用于紧急避孕同样有效。     

支架型IUD避孕失败后改用吉妮柔适IUD的临床效果观察

目的观察吉妮柔适宫内节育器的临床使用效果。方法选择既往有支架型IUD避孕失败者自愿再次放置吉妮柔适IUD的已婚育龄妇女550例,并进行12个月随访观察。结果吉妮柔适IUD12个月的累计脱落率(1.64%)、带器妊娠率(0.73%)、因症取出率(2.00%)均低于1995国家计生委IUD专家组提出优选IUD标准,即放置1年的脱落率≤4%、妊娠率≤2%、因症取出率≤4%,年续用率92.91%。结论吉妮柔适IUD是安全、高效、副作用低的新型IUD,值得临床推广应用。     

避孕节育干预对再次意外妊娠妇女知识和行为的影响

目的探讨避孕节育干预对再次意外妊娠妇女知识和行为的影响。方法随机选取2010年8月～2011年8月在本地区计划外早孕流产患者680例,予以避孕节育知识和行为干预,记录并分析相关观察指标。结果患者再次意外妊娠的发生率为4．70％。干预后患者短期避孕节育知识的知晓优良率、长期避孕节育知识的知晓优良率、紧急避孕节育知识的知晓优良率均高于干预前,差异有统计学意义（P〈0．05）。干预前后患者的避孕节育率比较,差异有统计学意义（P〈0．05）。结论采取避孕节育知识及行为干预能使流产患者达到良好的避孕效果。     

人工流产术后三种避孕方法的临床效果比较

目的探讨人工流产术后使用短效口服避孕药屈螺酮炔雌醇片（优思明）及宫内放置节育器和使用阴茎套避孕的临床效果。方法来本院进行人工流产术并自愿术后口服避孕药的65例女性列为屈螺酮炔雌醇片组,术后选择放置宫内节育器的69例作为IUD组,术后选择男式阴茎套避孕的58例为避孕套组。随访6个月,观察3组术后阴道出血时间、转经时间、术后月经量的变化及不良反应等情况进行临床对比。结果 3组患者人工流产术后出血时间相比较,屈螺酮炔雌醇片组和避孕套组阴道出血时间明显短于IUD组（P〈0.05）;3组患者术后月经恢复时间的比较差异均有统计学意义（P〈0.05）,屈螺酮炔雌醇片组月经恢复时间最短。术后3组患者月经量的变化情况比较差异有统计学意义（P〈0.05）,屈螺酮炔雌醇片组术后月经量小于以往月经量的患者有63.0%,明显多于避孕套组和IUD组,IUD组术后月经量大于以往月经量的患者为53.6%,明显多于屈螺酮炔雌醇片组和避孕套组。屈螺酮炔雌醇片组与IUD组不良反应率的比较差异有统计学意义（P〈0.05）,IUD组的不良反应发生率为36.2%,屈螺酮炔雌醇片组不良反应发生率为20.0%。结论人工流产术后即时服用屈螺酮炔雌醇片能促进子宫内膜恢复及较快恢复正常月经周期、降低术后阴道出血,值得临床上推广;IUD组不良反应主要有月经期延长、腰腹疼痛,但半年后基本恢复正常,所以可以作为长期避孕的首选方式。对于不能口服避孕药和放置宫内节育器避孕的患者,避孕套可作为首选避孕方式。     

Intrauterine devices used currently

A literature review of modern IUDs is presented. The larger the IUD, the more effective it is, but the rate of side effects also increases with the size. The Pearl Index for IUDs is presently .5-1.5. IUD use is indicated if hormonal contraceptive use is contraindicated. Many factors are involved in the effectiveness of IUDs. IUD use causes an increase in the number of macrophages and neutrophils, in IgG and IgM levels, and alkalic phosphatase and local fibrinolytic activity in the endometrium. The effectiveness of IUDs is enhanced by impregnating them with copper or outfitting them with a system to release progesterone. The abortion rate with IUD in situ ranges from about 50% for an inert IUD to nearly 60% for IUDs with active substances. Spontaneous abortions are twice as frequent with IUDs in situ, 3/4 of which occur in the first trimester. The rate of ectopic pregnancy with IUD in situ ranges from 2.9-9%. The expulsion rate is reported between 3 to 15/100 women-years. Bleeding, pain, and genital infection are other side effects of IUD use. The rate of perforation has been reported between 1:350 and 1:2500, depending on the type of IUD. IUDs are contraindicated if pregnancy is suspected, if any serious genital or pelvic infections or bleeding are present, if there are irregularities in the shape of the cervix or uterus, or if there is a history of extrauterine pregnancy or a suspicion of genital cancer.