B超监测下吉妮和TCu 380 A宫内节育器592例临床分析

目的:①多中心观察B超监测下放置吉妮和TCu380A宫内节育器(IUD)并随访12月的临床效果;②探讨吉妮IUD近期脱落的原因。方法:随机分组并在B超监测下放置吉妮IUD289例,TCu380AIUD303例,术后1、3、6、12月定期妇科及B超随访,记录受试对象病史、术时和术后情况,用SPSS10.0软件包进行数据处理,以生命表方法统计结果并行显著性检验。结果:①术后疼痛症状发生情况TCu380AIUD组明显高于吉妮IUD组,差异有显著性(P<0.05);术后6、12月随访月经紊乱以TCu380AIUD组为高,差异有显著性(P<0.05)。②术后6月、12月生命表结果提示吉妮IUD组因出血和疼痛的终止率较TCu380AIUD组低,差异有显著性(P<0.05)。③子宫后位者易发生带器妊娠,脱落与月经量及置器医生放置IUD质量有关。结论:吉妮IUD的避孕效果与国际推荐使用的TCu380AIUD一致,置器后出血和疼痛副反应少于后者。引入B超监测IUD放置过程对杜绝放置的不安全隐患有重要作用,也是在监控和验证放置IUD质量、年轻医生的培训过程及基层推广应用中必须注意的问题。     

放置吉妮IUD 620例临床效果观察

笔者于1999年1~12月对465例月经间期及155例人工流产后要求置器者放置吉妮宫内节育器(IUD),至2006年12月已完成7年的随访观察,现将结果报告如下。一、材料与方法1.研究对象1999年1~12月在本所门诊要求放置吉妮IUD妇女共620例,其中月经间期放置465例(I组),有1次分娩史妇女占94%,未产者占3%。,阴道分娩者占69.2%,既往月经规律,无放置IUD禁忌证;自愿要求人工流产后即时放置吉妮IUD者155例(II组),B超确诊为宫内妊娠6~9周,术前排除先兆流产及任何宫腔感染之可能,负压吸宫术中出血不多,子宫收缩良好。2.方法术前行常规检查并填写统一表格及…     

哺乳期妇女放置吉妮IUD的临床观察

吉妮宫内节育器是一种全新设计的无支架宫内节育器(IUD)。本站于 2 0 0 2年试用于临床。现将于哺乳期放置吉妮IUD 2 0 4例的临床避孕效果、手术安全性及副反应等情况总结报告如下。一、资料与方法1 对象　 2 0 4例受术者均为哺乳期健康妇女 ,自愿放置吉妮IUD ,年龄 2 4～ 32岁     

放置两种吉妮IUD 18个月临床效果分析

目的:观察吉妮致美与吉妮宫内节育器(IUD)使用18月的临床效果。方法:随机分组分别放置吉妮致美IUD517例,吉妮IUD508例,分别于置器后1、3、6、18个月进行随访,记录病史、放置IUD手术时间及术后随访情况,对数据进行生命表分析和Logistic多因素分析。结果:①随访18个月吉妮致美和吉妮IUD的带器妊娠率分别为0.60/100妇女年和0.61/100妇女年(P>0.05);②置器后6月内月经周期缩短、经量增多、月经期延长情况吉妮致美组低于吉妮组(P<0.05),因出血终止使用的吉妮致美组(1.2/100妇女年)明显低于吉妮组(6.69/100妇女年),P<0.05;③两组均无因疼痛所致的终止。④带器妊娠的危险因素为子宫内口至子宫底外缘距离大和子宫后屈;⑤脱落的危险因素则为体力劳动和哺乳期置器者。结论:吉妮和吉妮致美IUD避孕效率高;吉妮致美IUD对减少置器后近期出血及因出血所致终止率有明显效果,为吉妮IUD系列的扩大应用提供了更多的选择。     

IUD频繁脱落者放置吉妮IUD 200例临床观察

<正> 宫内节育器(IUD)具有安全、有效、简便、经济、长效、可逆等特点,在各种避孕方法中使用最为广泛。但是,由于宫颈条件、子宫排异性不同,以及IUD支架的硬度、大小、形状与官腔内形状不符等因素造成的IUD脱落,以及意外妊娠、带器妊娠、副反应等困扰着广大育龄妇女。第三代IUD——吉妮IUD以独特的宫内固定方式,理论上可以解决这一问题,本站自2001年1～12月为既往有IUD脱落2次或2次以上的妇     

放置吉妮IUD 2312例临床使用效果调查分析

目的:评估吉妮固定式宫内节育器(吉妮IUD)在海南省育龄妇女中的使用效果,以便指导在全省推广应用吉妮IUD的工作。方法:对2312例放置吉妮IUD的妇女进行问卷调查,了解置器后的1、3、6、12个月等临床使用效果。结果:在调查全省2312例使用吉妮IUD的育龄妇女中,发生脱落41例,占1.77%;带器妊娠13例,占0.56%,节育有效率为99.44%;因症取出38例,占1.64%;按照置器期限,把2312例进行分组,即满1月组(374例)、3月组(494例)、6月组(419例)和12月组(1025例)等4组,各组续用率依次为98.66%、99.19%、95.94%和92.97%。结论:育龄妇女放置吉妮IUD的副作用小、脱落率低、续用率高、适应证宽和节育有效率高,是可供妇女选择的一种长效避孕措施,值得推广应用。     

IUD频繁脱落者放置吉妮IUD200例临床观察

宫内节育器（IUD）是目前节制生育的主要避孕工具之一。它具有安全、有效、简便、经济、长效、可逆等特点，在各种避孕方法中使用最为广泛。尽管国内外IUD的种类不少，但置器后月经量多、山血、带器妊娠、IUD脱落、IUD下移等问题，一直是困扰广大育龄妇女，也是医务工作者关注且尚待解决的课题。第三代IUD-吉妮IUD有其独特的宫内固定方式，笔者通过对200例既往有IUD脱落2次或2次以上的妇女放置吉妮IUD，并随访12个月，从根本上解决了以上问题，现报告如下：     

带器失败妇女放置吉妮IN IUD380例效果观察

宫内节育器(IUD)是我国目前应用最为广泛的避孕工具，具有安全、有效、经济、简便及可逆等优点，育龄群众乐于接受。但是由于个体的差异和IUD的原因，导致部分妇女带器失败，非意愿停止使用。为了选择一种避孕效果好、副反应低的IUD，我市于2002年4月引进新型宫内节育器吉妮IN IUD并应用于临床，经对380例既往使用普通IUD失败的妇女放置吉妮IN IUD1年的定期随访观察，使用效果满意，现报告如下。     

150例吉妮IUD的临床效果观察

<正> 吉妮宫内节育器(IUD)是一种全新设计的无支架IUD,我中心于2001年试用于临床,并对150例放置者进行观察、随访,现报告如下:1 资料与方法1.1 观察对象 150例受术者均为已婚健康妇女,平均年龄28.5(21-41)岁,自愿选择放置吉妮IUD,并能接受定期随访。     

阴式B超监测不同分娩方式妇女放置IUD的临床观察

目的探讨阴式B超监测不同分娩方式妇女放置宫内节育器(IUD)的临床效果。方法在阴式B超监测下放置I-UD371例(其中256例为经阴道分娩,115例剖宫产分娩)为观察组;选择同期在传统盲视下放置IUD357例(其中245例为经阴道分娩,112例剖宫产分娩)为对照组,于放置后1、3、6、12个月进行随访。结果观察组的剖宫产组的置器时间明显短于对照组的置器时间,差异具有非常显著性(P<0.01);观察组的阴道分娩组的置器时间稍短于对照组的置器时间,但无显著性差异(P>0.05);2组置器时间比较有显著性差异(P<0.05)。使用IUD6个月:观察组的带器妊娠率、脱落率、因症取出率和续用率分别为0、0.27%、0.27%和98.10%;对照组分别为0.58%、2.05%、1.17%和94.15%。2组比较有显著性差异(P<0.05)。使用IUD12个月,观察组的续用率为94.05%,对照组为91.86%,2组比较有显著性差异(P<0.05)。结论阴式B超监测下放置IUD具有脱落率低、续用率高、副反应小的优点,值得临床推广。     

The frameless copper IUD (GyneFix) and the TCu380A IUD: results of an 8-year multicenter randomized comparative trial

Background

Clinical performance of the frameless copper IUD (GyneFix), designed to reduce side effects related to the frame of conventional IUDs, and TCu380A was compared.

Study Design

Randomized Multicenter randomized comparative trial. Parous women requesting and eligible to use IUD were admitted in 21 centers in eight countries in 1989-1993 and followed-up for up to 8 years.

Results

Two thousand twenty-seven women were randomized to the frameless IUD and 2036 to TCu380A; 43 insertions of the frameless IUD failed and none for TCu380A. First-year expulsion rate of the frameless IUD was 5.3 (95% CI: 4.4-6.4) per 100 and 2.5 (95% CI: 1.9-3.3) for the TCu380A; second- through eighth-year expulsion rates were not different. First-year pregnancy rates for the frameless IUD and TCu380A were 1.3 (95% CI: 0.9-2.0) and 0.5 (95% CI: 0.3-0.9), respectively; second- through eighth-year cumulative pregnancy rates were 1.2 (95% CI: 0.7-1.9) and 2.5 (95% CI: 1.8-3.4), respectively. The 8-year cumulative rates of ectopic pregnancy and IUD removal for pain were lower for the frameless IUD than for TCu380A. Removals for other reasons were not different.

Conclusions

The frameless IUD had more insertion failures, expulsions and pregnancies in the first year than TCu380A, but fewer pregnancies from the second through the eighth year, and by 8 years had fewer ectopic pregnancies and removals for pain.     

月经间期放置MYCu宫内节育器临床效果的比较性研究

目的:了解第三代爱母宫内节育器(MYCu IUD)在月经间期放置的临床效果、副作用及对生活质量的影响。方法:对要求放置IUD避孕的育龄妇女,在月经间期随机放置MYCu IUD(MYCu组,368例)与TCu 380AIUD(TCu380A组,369例),放置后1、3、6、12个月随访观察,记录使用情况。结果:置器后12个月MYCu组与TCu 380A组随访率分别为99.45%、100.00%;置器12个月累积续用率分别为每百妇女年94.02、91.87(P0.05);带器妊娠率分别为每百妇女年0.56、0.00(P=0.1703);脱落率分别为每百妇女年0.57、1.95(P=0.0947);无因IUD下移而停用者;因症终止率分别为每百妇女年3.01、6.03(P=0.0849)。置器后1、3、6个月副作用发生率MYCu组明显低于TCu380A组(P0.05)。两组对象相关生活质量均得到改善。结论:放置MYCu IUD较TCu 380AIUD疼痛和出血的副作用少,续用率、避孕效果与TCu 380AIUD相当,是一种临床效果好、副作用发生率较低的新型IUD。     

Continuation rates and reasons for discontinuing TCu380A IUD use in Tabriz, Iran

PURPOSE: The long-term effectiveness of copper-bearing intrauterine device (IUD) has been documented. This paper reports results from a 60-month study on the use of TCu380A IUD among 401 women in Tabriz, Iran. MATERIALS: In 2003, a 5% sample of women who had had an IUD inserted between May 1997 and May 1999 was taken. Analyses of discontinuation employed Tietze net rate life tables. RESULTS: Continuation of TCu380A IUD use by women at 1 month, 6 month, 1 year, 2 years, 3 years, 4 years and 5 years was 98.2, 89.3, 79.3, 68.3, 57.6, 49.5 and 45.0 per 100, respectively. Among women using the TCu380A IUD, the rate of termination due to pain/bleeding was significantly higher than the rate of termination due to other causes. Overall, two pregnancies were reported within 5 years after insertion. A third pregnancy occurred on Year 6. CONCLUSION: These findings indicate that family planning educators and health care providers should give more emphasis to counseling programs for women desiring IUD insertion and during follow-up.     

TCu220C与TCu380A IUD体外细胞毒性研究

目的:评价两种含铜宫内节育器体外细胞毒性。方法:采用TCu220C和TCu380A,10%FBS-DMEM浸提后,与L929细胞接触培养,通过倒置相差显微镜观察其形态,采取MTT(四唑盐)比色法量化细胞毒性,计算相对增值率(RGR),并进行毒性评价。结果:TCu220C表现出轻度的细胞毒性(1～2级),TCu380A表现出明显的细胞毒性(4级)。结论:相同形状的两种含铜宫内节育器因含铜面积不同,其表现出来的细胞毒性也不同,含铜面积越大,细胞毒性越大。     

TCu 380A IUD: a reversible permanent contraceptive method in women over 35 years of age

OBJECTIVE: The objective of the study was to evaluate the performance of the TCu 380A IUD in women who had been using the device for more than 10 years and who were 35 years of age or more on completion of the 10th year of IUD use. METHODS: A total of 228 women who had an IUD inserted between 1987 and 1992 were included in the study. The cutoff date for analysis was January 31, 2004. Clinical performance was evaluated by life-table analysis. The mean age of women at 10 years of use was 38.8+/-0.4 years and mean parity was 2.2+/-0.08 (mean+/-SD). The duration of follow-up beyond 10 years ranged from 1 to 72 months. No pregnancy was observed in 366 woman-years of observation beyond 10 years of use. The main reason for discontinuation was removal of the device because the clients had previously been informed that the IUD was not approved for use beyond 10 years. This reason accounted for a gross cumulative 6 years discontinuation rate of 42.5 per 100 women beyond 10 years. The other main reasons for discontinuation beyond 10 years of use were surgical sterilization, menopause and expulsion with gross cumulative 6-year termination rates of 19.2, 11.0 and 21.2 per 100 women, respectively. The cumulative continuation rate beyond 10 years was 67.0 at the end of the first year of follow-up and 21.2 at the end of the sixth year. CONCLUSION: We found no evidence that the TCu 380A IUD loses its effectiveness after 10 years of use. RESULTS: The concept that women who have insertion of a TCu 380A IUD at the age of 25 years or older could use this IUD as a reversible but permanent method of contraception up to the menopause continues to be supported by the accumulation of evidence, although definitive evidence remains to be obtained.     

TCu220C与TCu380AIVD体外细胞毒性研究

目的:评价两种含铜宫内节育器体外细胞毒性.方法:采用TCu220C和TCu380A,10?S-DMEM浸提后,与L929细胞接触培养,通过倒置相差显微镜观察其形态,采取MTT(四唑盐)比色法量化细胞毒性,计算相对增值率(RGR),并进行毒性评价.结果:TCu220C表现出轻度的细胞毒性(1～2级),TCu380A表现出明显的细胞毒性(4级).结论:相同形状的两种含铜宫内节育器因含铜面积不同,其表现出来的细胞毒性也不同,含铜面积越大,细胞毒性越大.     

两种新型含铜IUD对宫颈沙眼衣原体阳性率影响的研究

本文报道了同期放置的TCu380A及GyneFix两种新型含铜宫内节育器在放置1年及2年时与对照组宫颈砂眼衣原体(CT)阳性率的比较。TCu380A组放置1年时阳性率为5.63％,2年时为4.92％;GyneFix组放置1年时阳性率为4.62％,2年时为5.08％,两组含铜IUD放置1年及2年时各组比较差别均无显著意义(P>0.05);对照组CT阳性率为15.18％,与上述各组比较差别均有显著意义(P<0.05)。本文结论认为含铜IUD对宫颈CT感染有抑制作用。     

放置宫内节育器10年随访观察

采用B超对某大学121例放置宫内节育器的妇女进行10年定期随访观察，发现：（1）宫内孕5例，宫外孕1例；带器妊娠率4．96％（1．09％～8．83％）；（2）合并子宫肌瘤4例，宫内膜异位2例，卵巢囊肿3例，畸胎瘤1例；合并症发病率8．26％（3．36％～13．17％）。由此说明，B超在IUD术后随访中的重要意义。