宫血宁胶囊预防放置宫内节育器后子宫异常出血的效果

目的:分析宫血宁胶囊预防放置IUD致子宫异常出血的效果。方法:应用meta分析方法的固定效应模型,对国内1990～2010年采用宫血宁胶囊预防放置IUD致出血副反应,并以空白或安慰剂对照的随机分组研究进行定量合并分析。结果:治疗组1168例患者中87例经量增多或经期延长,对照组1168例患者中392例经量增多或经期延长。合并优势比(OR)=6.79,95%置信区间(CI)为5.25～8.78,两者间差异有统计学意义(合并效果检验统计量Z=14.58,P<0.001)。结论:宫血宁胶囊预防放置IUD出血副反应的效果肯定,可以显著减少经量增多和经期延长的发生。     

宫血宁治疗宫内节育器致子宫异常出血的效果评价

目的 观察宫血宁治疗放置宫内节育器出血的临床疗效.方法 将135例放置宫内节育器异常出血患者随机分为2组,观察组68例,采用纯中药制剂宫血宁胶囊治疗,对照组67例,采用西医消炎痛及安络血治疗,两组均观察3个月经周期.结果 观察组治愈41例,有效19例,无效8例,总有效率为88.2%;对照组治愈27例,有效21例,无效19例,总有效率为71.7%.两组疗效比较差异有显著性.结论 宫血宁具有缩宫、止血、消炎等作用,对治疗宫内节育器致异常出血疗效显著,值得推广应用.     

立止血联合宫血宁治疗宫内节育器术后子宫异常出血的临床研究

目的 探讨立止血联合宫血宁治疗宫内节育器术后子宫异常出血的临床效果.方法 本研究于2012年2月-2013年2月对在如皋市城西医院收治的宫内节育器术后发生子宫异常出血患者采用常规治疗的基础上进行立止血联合宫血宁治疗,并与仅采用常规治疗的对照组进行临床效果及不良反应比较.结果 研究组患者在治疗后出血天数、滴血天数、出血/滴血次数及月经天数均较对照组明显减少,且差异具有统计学意义（t=4.32、5.31、3.05、3.18,P＜0.05）.研究组患者临床治疗总有效率明显高于对照组,且差异具有统计学意义（x2=8.47,P＜0.05）.结论 立止血联合宫血宁治疗宫内节育器术后子宫异常出血的临床疗效确切,不良反应发生率低,值得临床推广使用.     

宫血宁治疗宫内节育器致子宫异常出血的效果评价

目的观察宫血宁治疗放置宫内节育器出血的临床疗效。方法将135例放置宫内节育器异常出血患者随机分为2组,观察组68例,采用纯中药制剂宫血宁胶囊治疗,对照组67例,采用西医消炎痛及安络血治疗,两组均观察3个月经周期。结果观察组治愈41例,有效19例,无效8例,总有效率为88.2%;对照组治愈27例,有效21例,无效19例,总有效率为71.7%。两组疗效比较差异有显著性。结论宫血宁具有缩宫、止血、消炎等作用,对治疗宫内节育器致异常出血疗效显著,值得推广应用。     

宫血宁防治放置节育器异常出血的临床观察

官内节育器（IUD）是一种安全、有效、简便、经济及可逆性强的避孕方法，然而有部分妇女放置宫内节育器后会出现阴道出血，月经量增多，经期延长，经间点滴出血等副反应。我们采取宫血宁治疗放置节育器异常出血，取得满意效果。我们对132例置器的妇女随机分为服药组和对照组，将宫血宁组作为服药组，进行同期观察，现将结果报道如下：     

宫血宁胶囊减少放置IUD后阴道出血的有效性和安全性研究

目的:研究宫血宁胶囊减少放置IUD后阴道出血的有效性和安全性。方法:采用开放、多中心、非对照、临床前瞻性研究的方法,观察研究对象自放置IUD日或因放置IUD后有阴道异常出血就诊日起服用宫血宁胶囊,3次/天,2粒/次,共6天。服药后2周以上必须随访1次,以后按放置IUD常规随访,包括主诉、不良反应、服药后阴道流血停止的天数等。结果:共接纳对象28175例,放置IUD后止血时间在9天内者占90.33%;能按规定服药6天者占92.34%;不良事件发生72例,占0.26%,与宫血宁可能相关的不良事件占0.13%,无严重不良事件。结论:宫血宁胶囊能减少放置IUD后阴道出血,可接受性好,安全性高,无严重不良事件发生。     

宫血宁合归脾丸治疗宫内节育器月经失调的临床效果观察

宫血宁合归脾丸能够有效的治疗子宫内放置节育器后导致的月经失调,其治疗效果远远高于西药的治疗效果。因此宫血宁合归脾丸值得在治疗宫内放置节育器后月经失调中推广和应用。     

放置宫内节育器后子宫异常出血相关因素分析

目的:分析放置宫内节育器(IUD)后发生子宫异常出血的影响因素。方法:将因使用IUD而发生子宫异常出血的妇女65例作为观察组,使用IUD而无不良反应的妇女60例作为对照组。通过病例资料和拟定的调查问卷表分析放置IUD后子宫异常出血的危险因素。结果:两组年龄、放置IUD后用药、人工流产次数、高血压史、吸烟史等比较无统计学差异(P0.05)。观察组妇科炎症、剖宫产史比例均大于对照组,放置IUD时间低于对照组(P0.05)。单因素和多因素logistic回归分析结果表明,使用IUD后子宫不规则出血的危险因素为妇科炎症、剖宫产史和放置IUD时间。结论:对放置IUD后子宫异常出血的妇女,应积极给予治疗,放置IUD时充分考虑到妇科炎症、剖宫产史和放置IUD时间,做好术前咨询和术后随访工作,提高IUD的续用率。     

宫血宁防治药物流产后阴道出血疗效观察

目的探讨应用中成药(宫血宁胶囊)、中药(生化汤)防治药物流产后阴道出血的治疗效果.方法对1印例自愿药物流产者分别采用口服宫血宁胶囊和服用中药生化汤治疗,比较两组药物流产疗效和出血情况.结果中成药宫血宁胶囊组与中药生化汤组阴道出血15 d内干净率分别占96.25%和95%.结论中成药宫血宁胶囊与中药生化汤治疗流产后阴道出血效果理想,两者差异无显著性.     

宫血宁胶囊治疗放置T铜380A后子宫出血的临床对比性研究

目的:观察宫血宁胶囊治疗放置T铜380A宫内节育器后子宫出血的疗效。方法:采用前瞻性、随机分组、双盲对比研究,观察宫血宁对放置宫内节育器后月经增多的预防与治疗效果。结果:放置宫内节育器后,两组月经血量较放置前均增多,但宫血宁组明显少于安慰剂组(P<0.05)。放置后第1、3、5周期两组血红蛋白水平无显著性差异,第6周期宫血宁组高于安慰剂组(P<0.05);月经过多发生率在放置后第1、3、5、6周期宫血宁组低于安慰剂组(P<0.05)。结论:在放置T铜380A后服用宫血宁胶囊,可有效减少月经血量,减少月经过多的发生率。     

放置含铜IUD后异常出血者子宫内膜组织铜离子浓度和血管内皮生长因子表达关系的研究

目的:分析含铜宫内节育器(IUD)TCu380AIUD中铜溶蚀、子宫内膜组织中铜离子和血管内皮生长因子(VEGF)浓度与子宫异常出血的关系。方法:收集32例因子宫异常出血和36例月经规律但因非医疗原因取器者,选择18例未放置IUD且月经规律的妇女作对照,进行TCu380AIUD体外铜离子释放量的测定,检测各组妇女子宫内膜组织铜离子和VEGF的含量。结果:子宫异常出血妇女的CuIUD日铜溶蚀量高于月经规律妇女(P<0.05),子宫异常出血妇女的内膜组织铜离子含量和VEGF表达明显高于月经规律妇女的内膜组织(P<0.05),子宫内膜VEGF表达与子宫内膜组织铜离子含量呈正相关。结论:CuIUD的高溶蚀量可能导致子宫内膜组织铜离子含量的增加,造成子宫内膜VEGF分泌增多,进而发生子宫异常出血。     

妇科清热利湿化瘀制剂在放置宫内节育器后的应用价值研究

目的:探讨妇科清热利湿化瘀制剂在放置宫内节育器术后的应用价值。方法:研究对象随机分为观察组和对照组,观察组675例,于置器术后即服用清热利湿化瘀类中药复方制剂,连服7d,以后每月于月经来潮第1天开始重复以上治疗,共3个周期;对照组696例,于术后口服头孢呋辛酯片剂3d及维生素E胶丸7d,后两个月经周期口服维生素E胶丸7d,共3个周期。观察两组放置IUD后6个月内月经期、月经量异常、经间期出血、腰腹部疼痛、白带异常的发生情况以及12个月内的因症取出率和续用率。结果:观察组月经期、月经量异常、经间期出血、腰腹部疼痛、白带异常的发生率均低于对照组;观察组12个月内因症取出率显著低于对照组,续用率显著高于对照组。结论:妇科清热利湿化瘀复方制剂有助于宫内节育器放置后的早期适应,对置器后的不良反应能起有效的预防作用。     

Barriers to intrauterine device insertion in postpartum women

OBJECTIVE: The objective of this study was to determine the proportion of postpartum women at the University of New Mexico who choose an IUD for contraception, the number who actually obtain one and the barriers to postpartum IUD insertion. METHOD: We conducted a retrospective chart review of 1627 postpartum women who delivered at the University of New Mexico. Those women who indicated at hospital discharge that they desired an IUD comprised the study group of 193 women. Medical records were reviewed to identify the timing of IUD placement. If an IUD was not inserted, we attempted to determine the reason by reviewing clinic records. RESULTS: Twelve percent of postpartum women requested an IUD. Records were available for 114 women. Of these, only 69 (60%) actually obtained an IUD. Barriers to postpartum IUD insertion included provider advice against the IUD, patient failure to return for a postpartum visit and early repeat pregnancy. CONCLUSION: We conclude that postpartum women desiring an IUD may have difficulty obtaining one.     

Postplacental intrauterine device insertion at a teaching hospital

Objective

To determine whether postplacental intrauterine device (IUD) insertion can be safely and effectively performed within a teaching program.

Study Design

This was a prospective cohort of 177 subjects planning vaginal delivery enrolled antenatally who desired postplacental IUD insertion of either the copper T380A IUD or levonorgestrel IUS. Insertions were performed primarily by resident physicians following a training session. Follow-up included a 4- to 8-week visit and telephone calls at 3 and 6 months.

Results

Ninety-nine subjects underwent successful postplacental IUD insertion of 100 attempts. Seventeen expulsions (17%) were noted: 10 complete and 7 partial. The study identified no differences in outcome by training level; however, the study lacked statistical power to evaluate anything other than large differences.

Conclusion

Postplacental IUD insertions can be safely and effectively performed within a training program.

Implications

A training protocol may safely and feasibly be initiated among physicians, advanced practice clinicians or trainees with no prior experience with postplacental IUD insertion. By initiating this practice, access to highly effective contraception may increase for patients who have difficulty returning for a visit or otherwise receiving effective methods.     

吲哚美辛治疗置IUD后出血者子宫内膜形态学变化观察

目的:研究吲哚美辛对放置宫内节育器后出血副反应者子宫内膜不同部位形态学影响。方法:纳入宫内节育器出血副反应者(治疗组)49例;输卵管性不孕行输卵管插管术及子宫全切术患者(对照组)20例。治疗组给予吲哚美辛口服,定点获取治疗组宫内节育器压迫区、移行区、远器区子宫内膜及对照组相应部位子宫内膜,观察两组子宫内膜形态学、显微和超微结构,对内膜不同区域进行比较。结果:治疗前,治疗组子宫内膜显微、超微结构明显异常,较之对照组存在内膜发育不同步的剥脱/修复障碍,内膜损伤程度与距离宫内节育器的远近成反比;治疗后,治愈者子宫内膜剥脱/修复障碍消失或明显减轻,未愈者不同区域子宫内膜仍存在程度不一的形态学损伤和剥脱/修复障碍。结论:放置宫内节育器出血副反应者存在以剥脱/修复障碍为主的内膜形态学异常,纠正和预防其形态学改变可能是有效的防治机制。     

Vaginal flora changes on Pap smears after insertion of levonorgestrel-releasing intrauterine device

Background

The levonorgestrel intrauterine system (LNG-IUS) combines a uterine foreign body and the continuous release of low-dose levonorgestrel for contraception. Its influence on the rate of vulvovaginal infections and flora disturbance is insufficiently known, but important for contraceptive advice in women, especially those who develop recurrent vaginosis or Candida vulvovaginitis.

Study Design

Slides of 286 women who had a Pap smear taken before and 1 to 2 years after placement of a LNG-IUS were blindly reviewed for the presence of abnormal vaginal flora (AVF), bacterial vaginosis (BV), aerobic vaginitis (AV) and Candida vaginitis (CV).

Results

Prior to insertion, there were no differences in vaginal flora abnormalities between women using different kinds of contraception. LNG-IUS users did not have different rates of AVF, BV, AV or CV, but the general risk to develop any infection was increased. Uterine bleeding after insertion did not seem to predict a different flora type.

Conclusion

We found that Pap smears suggested more vaginal infections after 1 year of LNG-IUS use than prior to insertion of the device.     

双氯芬酸钾用于预防放置宫内节育器疼痛的临床研究

目的:观察双氯芬酸钾用于预防放置宫内节育器(IUD)所致疼痛的效果。方法:随机选取经剖宫产分娩后和阴道分娩后的两组妇女各100例,两组分别放置宫铜200IUD和TCu380IUD:剖宫产分娩后放置宫铜200IUD的妇女49例(观察组24例,对照组25例),放置TCu380IUD的妇女51例(观察组26例,对照组25例)。阴道分娩后放置宫铜200IUD的妇女50例(观察组和对照组各25例),放置TCu380IUD的妇女50例(观察组和对照组各25例)。观察双氯芬酸钾在置器术中、术后30min、术后6h、术后当晚睡前及术后第3日晚睡前预防疼痛的效果及服药的副反应等。结果:阴道分娩后置器的妇女,观察组和对照组在术中、术后30min、术后6h、术后当晚睡前及术后第3日晚睡前的疼痛分级差异均无统计学意义(P>0.05)。剖宫产分娩后放置宫铜200IUD的妇女,观察组和对照组比较,在术中及术后第3日晚睡前疼痛分级差异有统计学意义(P<0.05);放置TCu380IUD的妇女,观察组和对照组术后30min的疼痛分级差异有统计学意义(P<0.05)。结论:双氯芬酸钾用于预防剖宫产分娩后放置IUD所致疼痛有一定的效果,但未发现其能预防阴道分娩后放置IUD所致的疼痛。