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1.
方可娟  薛丽 《生殖与避孕》1998,18(6):354-360
本要用国家“八五”科技攻关项目,“国产皮下埋植避孕方法多中心研究(扩大应用)”资料,分析中国妇女使用国产皮埋植剂后月经异常发生率及影响因素,月经异常是皮下埋植剂最主要的副反应,埋植后半年内,一半以上的妇女主诉有月经异常发生,采秀单因素和Logistic多元逐步回归对月经异常副反应进行分析,结果表明;月经异常主与年龄,化程度,体重,埋植时是否哺乳,末次妊娠结局,末次避孕方法和埋植剂类型有关,年龄  相似文献   

2.
因月经异常停用国产皮下埋植剂的影响因素分析   总被引:9,自引:0,他引:9  
本文采用国家“八·五”科技攻关项目“国产皮下埋植避孕方法多中心研究 (扩大应用 )”资料 ,分析中国妇女使用国产皮下埋植剂后因月经异常停用的影响因素。月经异常是皮下埋植剂最主要的停用原因 ,二年末因月经异常的累积停用率 I 型和 II 型分别为8.96 %和 7.84%。采用 COX多元逐步回归分析因月经异常停用的影响因素。结果表明 :文化程度高、产次低者因闭经停用的风险率较高 ,农民较其它职业者因闭经停用的风险率低 ,I型埋植剂因闭经停用的风险率高于 II型 ;文化程度高、体重轻、埋植时不哺乳、产次低、末次避孕方法使用 IUD或屏障法者因“其它”月经异常 (指除闭经以外的其它月经异常 )停用的风险率较高。农民较其它职业者因“其它”月经异常停用的风险率低 ;不同地区的妇女因月经异常停用的风险率不同。本研究结果提示 :应在手术前有针对性地做好咨询服务工作 ,以提高皮下埋植避孕方法的可接受性  相似文献   

3.
本研究在全国11个省100个分中心对国产Ⅰ型和Ⅱ型皮下埋植剂进行临床多中心比较研究,共接收合格对象19673例,目前已完成一年随访。一年随访率95.9%,继续使用率分别为95.49%(Ⅰ型)和95.80%(Ⅱ型)。埋植后6个月和12个月时副反应发生率分别为5845%和4732%。副反应的发生率有随着时间的增长而减少的趋势。6个月时Ⅰ型皮下埋植剂和Ⅱ型皮下埋植剂副反应发生率较接近。12个月时到反应发生率1型皮下埋植剂(48.90%)显著地高于巨型皮下埋植剂(45.78%)(P<0.001)。主要副反应为月经失调,约为副反应发生率的92%~94%。其中月经频发、不规则出血和点滴出血等问题发生率高于月经稀发和闭经。闭经、月经稀发/口量少和点滴出血的发生率Ⅰ型高于Ⅱ型。一年观察中,因月经问题而终止使用者占总终止人数的76%,与月经问题有关的一年累积终止率Ⅰ型为每百妇女3.44,Ⅱ型为3.21。一年的累积妊娠率Ⅰ型和Ⅱ型分别为每百妇女0.029和0.073,其间未见显著性差异。一年观察研究表明,两种国产皮下埋植剂的副反应发生率和避孕效果以及一年的续用率与进口的Norplant相似。  相似文献   

4.
<正>皮下埋植避孕剂是一种缓慢释放孕激素的长效可逆避孕方法,具有高效、长期、简便、可逆、安全等优点,但存在的一些副反应及安全性问题仍然影响其使用及推广,也影响到了皮下埋植避孕剂的研究及发展。1 皮下埋植引起的副反应1.1 阴道流血阴道流血模式改变是最常见的副反应,也是导致停用的最常见原因。植入后5年,由于出血模式改变导致累积停用率分别为17.0/每百妇女和15.26/每百妇女,依托孕烯植入剂的停用率为11/每百妇女[1]。皮下埋植  相似文献   

5.
目的:初步探讨血浆内皮素与皮下埋植剂使用者子宫异常出血的相关性。方法:采用前瞻性自身对照研究方法,对29名妇女在埋植手术前后月经周期不同阶段取4次静脉血;本研究前已使用皮下埋植剂的59名随访妇女组成已埋植组,取1次静脉血。应用放免方法测定血浆内皮素、雌激素、孕激素含量。结果:29例自身对照组妇女雌激素水平不论在月经周期的哪一阶段与埋植前比较均无明显改变,埋植后月经紊乱者较月经正常者雌激素、孕激素水平也无明显差异,血浆内皮素水平月经紊乱者偏高(但尚无统计学差异),且月经紊乱者较月经正常者埋植前月经周期各阶段血浆内皮素水平也明显增高,尤以早增期、中增期明显,P<0.05。已使用埋植剂组的59名妇女,月经紊乱者血浆内皮素水平较月经正常者血浆内皮素也明显增高,P<0.05。结论:血浆高内皮素水平可能和埋植后子宫异常出血存在一定关系。  相似文献   

6.
中国妇女使用狄波普维拉长效避孕针的多中心临床研究   总被引:2,自引:0,他引:2  
本研究为一开放性试验,1994例对象每3个月接受一次狄波普维拉避孕针注射,观察1年,共使用20294.3妇女月,仅发生1例意外妊娠,1年使用有效率为99.94%,总续用率为72.87%。该避孕针对体重和血压无明显影响,其主要副反应为卢、滴出血、出血期长、闭经等,也是停针的主要原因。随着继续用针,与出血问题有关的主诉会逐渐减少,而闭经主诉逐渐增加,哺乳妇女各种副反应发生率均较非哺乳妇女为低,连续用针率较高,绝大多数哺乳对象自觉对泌乳无影响。本研究结果表明,对于中国育龄妇女,使用狄波普维拉避孕针为一高度有效的避孕方法,在提供充分的咨询和服务条件下,使用得当,可有良好的可接受性,提高续用率,尤其适合哺乳妇女,可作为产后哺乳期避孕而推广使用。  相似文献   

7.
目的 评估依托孕烯单根皮下埋植剂(Implanon(R))的避孕效果、月经模式的改变和对痛经的治疗效果.方法 以接受依托孕烯单根皮下埋植剂避孕的妇女200例为研究对象,术后随访24个月,分析其避孕效果,痛经缓解程度,不良反应和继用率.结果 术后24个月,190例受试者完成随访,随访率95%.随访期间,无1例受试者意外怀孕,避孕率100%.另外,61例埋植前有痛经的受试者,55例埋植后痛经得到缓解,缓解率为90.2%.主要不良反应为月经模式改变141例(74.2%),包括不规则阴道流血60例(31.6%)、闭经6例(3.2%),经期延长63例(33.2%)、月经频发41例(21.6%);月经稀发20例(10.5%)、经量减少66例(34.7%)、经量增加10例(5.3%).其他不良反应还有体质量增加32例(16.8%),痤疮21例(11.1%),激素相关不良反应63例(33.2%).随访期间,16例受试者,包括阴道不规则流血(10例)、闭经(6例)提前取出植入剂,继用率为91.6%.结论 依托孕烯单根皮下埋植剂的避孕效果好,有效缓解痛经程度,安全可靠,继用率高,可在临床上推广应用.  相似文献   

8.
本研究对69例皮下埋植避孕者根据阴道出血类型不同分为月经规则组、月经紊乱组、闭经组,并对其分别进行生殖激素测定,监测卵泡生长发育及宫颈评分。结果表明:埋植期间月经规则组除黄体期P水平较正常对照组降低外(P<0.01),其它生殖激素均在正常范围内波动;月经紊乱组及闭经组P和E2低于正常对照组黄体期,相当于正常对照组卵泡期低水平。B超监测卵泡表现三种类型:1.卵泡逐渐成熟并排卵;2.卵泡逐渐长大并在整个周期内持续存在;3.卵泡未发育。研究结果提示黄体功能不足是皮下埋植避孕的作用机理之一,并说明皮下埋植者月经失调和生殖激素及卵泡发育特征之间的变化与LNG的抑制有关,研究结果进一步证实皮下埋植剂具有高效、安全的优点,对扩大推广应用皮下埋植避孕法起到指导作用。  相似文献   

9.
皮下埋植剂是最有效、可逆的节育方法之一,比大多数宫内节育器的避孕效果好,在头三年的效果和节育术相同.方法简便,埋植剂一旦放入,除按时随访,妇女不必为之操心.作用长效,在埋植24小时后,埋植剂就起避孕作用.一组埋植剂可以避孕五年.又具可逆,当埋植妇女希望终止使用或要求怀孕时,可去医院或诊所取出埋植剂,可立即恢复正常月经,并可受孕.  相似文献   

10.
延期使用左炔诺孕酮Ⅰ型皮下埋植剂避孕的有效性观察   总被引:1,自引:0,他引:1  
目的探讨延期使用左炔诺孕酮Ⅰ型皮下埋植剂避孕的有效性.方法对299例使用左炔诺孕酮Ⅰ型埋植剂超过5年以上的妇女,观察其避孕的有效性及子宫内膜的形态学变化.结果延期使用组月经表现较为正常,累积妊娠率为0.33/100妇女年.植入后平均体重和血红蛋白均增加,与植入前比较差异有显著性,P<0.05.对48例延期使用者进行观察,宫腔镜直视下见子宫内膜变薄者37例,占77.08%,且内膜覆盖良好;光镜下子宫内膜腺体数量减少,分布不均匀,部分呈萎缩型改变,间质蜕膜样改变,疏松,轻度水肿;电镜下腺上皮细胞呈低柱状,胞体变小,微绒毛脱落,稀疏,分泌颗粒减少,线粒体肿胀,外膜消失,基质变淡,甚至呈空泡状,粗面内质网扩张,此外,间质细胞出现细胞凋亡.结论延期使用左炔诺孕酮Ⅰ型皮下埋植剂避孕是有效的,可抑制子宫内膜的发育,对子宫内膜是安全的;体重和血红蛋白的增加不是影响左炔诺孕酮埋植剂延期使用的因素.  相似文献   

11.
目的:探讨人工流产术后是否可即刻放置依托孕烯植入剂进行避孕。方法:要求避孕的66例因非意愿妊娠行人工流产术后妇女即刻放置依托孕烯植入剂为研究组,另同期征集84例健康妇女于月经期放置该植入剂作为对照组,术后1、6、12个月随访,随访阴道出血情况,植入剂取出原因,并在放置12个月时进行满意度调查。结果:在放置12个月期间所有对象均未怀孕。研究组闭经/出血稀发发生率为53.0%,出血频发/出血延长发生率为15.1%,对照组闭经/出血稀发发生率为58.4%,出血频发/出血延长发生率为27.3%;满12个月时,研究组取出20例,续用率为69.7%,满意度为69.6%;对照组取出22例,续用率为73.8%,满意度为72.6%。结论:人工流产术后即刻放置依托孕烯植入剂与月经期放置效果相同,人工流产术后妇女即刻放置依托孕烯植入剂进行避孕也是一个较合适的放置时机。  相似文献   

12.
Summary. Self-perceived menstrual patterns have been investigated in a sample of 2115 women aged 18–9 years using a postal questionnaire. Seven aspects of 'abnormal' menstruation were denned: prolonged periods, heavy periods, frequent periods, irregular periods, intermenstrual bleeding, painful periods and severe premenstrual syndrome. Women who used oral contraceptives were less likely than other women to report any of the seven menstrual abnormalities except for intermenstrual bleeding and severe premenstrual tension. Women who used an intrauterine contraceptive device (IUCD) reported prolonged, heavy, and frequent periods and intermenstrual bleeding more often than other women, but they did not report painful periods with undue frequency. Women who had had a tubal sterilization generally reported menstrual patterns similar to, or slightly less favourable than, women using no contraception or contraceptive methods other than the pill or the IUCD. There was a significant association between smoking habits and each of the abnormal menstrual patterns except for severe premenstrual tension. In every case, the effect of smoking was unfavourable and in almost every case, current smokers reported the worst experience, with ex-smokers occupying an intermediate position. We believe that these data are of considerable clinical significance and that they offer a basis for a conservative approach to managing menstrual disorders in some women.  相似文献   

13.
Self-perceived menstrual patterns have been investigated in a sample of 2115 women aged 18-49 years using a postal questionnaire. Seven aspects of 'abnormal' menstruation were defined: prolonged periods, heavy periods, frequent periods, irregular periods, intermenstrual bleeding, painful periods and severe premenstrual syndrome. Women who used oral contraceptives were less likely than other women to report any of the seven menstrual abnormalities except for intermenstrual bleeding and severe premenstrual tension. Women who used an intrauterine contraceptive device (IUCD) reported prolonged, heavy, and frequent periods and intermenstrual bleeding more often than other women, but they did not report painful periods with undue frequency. Women who had had a tubal sterilization generally reported menstrual patterns similar to, or slightly less favourable than, women using no contraception or contraceptive methods other than the pill or the IUCD. There was a significant association between smoking habits and each of the abnormal menstrual patterns except for severe premenstrual tension. In every case, the effect of smoking was unfavourable and in almost every case, current smokers reported the worst experience, with ex-smokers occupying an intermediate position. We believe that these data are of considerable clinical significance and that they offer a basis for a conservative approach to managing menstrual disorders in some women.  相似文献   

14.
宫内节育器副反应原因探讨——附宫腔镜和病理组织学检查   总被引:17,自引:1,他引:17  
<正> 宫内节育器(IUD)是我国育龄妇女应用最广泛的避孕工具。但约有7~15%妇女于放置IUD后出现月经异常、异常出血及腹痛等副作用而停用,影响IUD的续用率。本文根据放置者的病史、体格检查,宫腔镜和子宫内膜病理组织学检查的结果探讨IUD引起副作用的一些原因。  相似文献   

15.
ObjectiveTo describe the opinion and experience of Brazilian women regarding menstruation and the use of combined oral contraceptives (COCs) to control monthly bleeding and induce amenorrhea.MethodsWomen attending regional public healthcare clinics for non-gynecologic conditions, and female members of staff from university schools unrelated to the field of medicine completed a questionnaire.ResultsOf the 1111 women interviewed, 64.3% reported disliking menstruation. The desired frequency of bleeding was never (65.3%), less than monthly (18.2%), and every month or more often (16.5%). More than 60% of the women reported that they would use COCs to control menstrual bleeding, 82.0% would use COCs to reduce the amount of bleeding experienced, and 86.1% would use COCs to induce amenorrhea. When compared with women who disliked menstruation, those who reported that they liked to experience monthly bleeding had fewer years of schooling (OR1.98; 95% CI, 1.30–2.97), low socioeconomic status (OR 1.66; 95%CI, 1.12–2.46), fewer days of menstruation each month (OR 1.62; 95%CI, 1.11–2.36), and 1 or more child (OR 1.13; 95%CI, 1.01–1.26).ConclusionMany of the women surveyed disliked monthly menstruation and were interested in the use of COCs to control menstrual bleeding and induce amenorrhea.  相似文献   

16.
489 women from Sweden (n = 296) and from Great Britain and Germany (n = 193) took part in a test of 2 O.C. (oral contraceptive) preparations. 254 women used the triphasic SH B 264 AB preparation, while 235 women used Neovletta. A total of 2777 cycles was observed, during which no pregnancies occurred. The mean menstrual duration decreased nearly 2 days among Neovletta patients and 1 1/2 days among SH B 264 AB users (p .001). The rate of amenorrhea after 3 and 6 cycles was 1.6% and .5% respectively among SH B 264 AB users and 1.4% and 2.1% respectively among Neovletta users. Menstrual bleeding decreased. The rate of amenorrhea was significantly (p .001) greater among Neovletta users. The volume of menstrual bleeding decreased for users of both preparations. The incidence of bleeding irregularities was greater among those using Neovletta. 14.7% of the women discontinued O.C. use during the study, ca. 8% due to medical reasons, at about the same rate for both preparations. SH B 264 AB users more often reported side effects; the most frequent side effects for both preparations were headaches, mastodynia, and nausea.  相似文献   

17.
Abstract

Purpose: The purpose of this study is to evaluate the menstrual profile in users of the etonogestrel (ENG)-releasing implant (Nexplanon®) and the possible correlation with anthropometric variables.

Methods: Ninety-two healthy women, desiring long-term contraception with the ENG implant were enrolled in a prospective observational study. Anthropometric variables were measured at baseline and after 3, 6, 9, and 12 months. Patients recorded daily the occurrence of any bleeding or spotting. The bleeding/spotting pattern was evaluated over consecutive 90-day intervals (“Reference Periods” – RPs). Patients who showed a favourable bleeding profile (amenorrhoea, infrequent, or normal bleeding) for 50% or more of the RPs were assigned to group A, while patients with a favourable bleeding profile for less than 50% of the RPs were assigned to group B.

Results: Sixty-eight women (79%) were assigned to group A; 18 (21%) to group B. Group B had a lower baseline body mass index (BMI) than group A (24.84?±?4.95?kg/m2 versus 20.75?±?4.41?kg/m2; p?<?0.005).

Conclusions: The ENG sub-dermal implant is a well-tolerated contraceptive method, with a high proportion of women experiencing a favourable bleeding profile. The lower basal BMI in Group B in comparison with Group A may account for the higher percentage of irregular bleeding.  相似文献   

18.
Norplant皮下埋植避孕法对子宫内膜影响的临床病理研究   总被引:8,自引:0,他引:8  
<正> Norp1ant皮下埋植剂(以下简称埋植剂)避孕是一项新的、女用的长效避孕方法,避孕效果好,继续使用率高,可逆性强,已有44个国家355,000人应用。现将30例应用Norplant皮下埋植剂避孕妇女的31人次及埋植剂取出后置宫内节育器时采取子宫内膜3例介绍如下:  相似文献   

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