围绝经期使用宫内节育器避孕对生殖健康的影响研究

目的:探讨围绝经期使用宫内节育器(IUD)避孕对生殖健康的影响。方法:采用分层整群随机抽样方法,对围绝经期使用IUD避孕妇女(615例,IUD组)和围绝经期采用其他方法避孕妇女(538例,对照组)进行生殖健康和围绝经期症状问卷调查,并进行相应的健康检查;采用logistic多元回归方法对IUD组与IUD使用相关终止因素进行分析。结果:与对照组比较,IUD组月经周期不规则发生率减低,腰腹痛症状高于对照组,附件炎和子宫肌瘤或宫颈肥大发生率低于对照组,IUD对经期和痛经的影响随放置时间的延长明显下降,差异均有统计学意义(P<0.05);不同种类IUD对月经周期、经期、经量和痛经的影响差异有统计学意义(P<0.05);两组经量、痛经、经期、围绝经期症状、阴道炎和宫颈糜烂发生率,血红蛋白水平差异无统计学意义(P>0.05);多因素分析显示,放置IUD时间对月经周期、经量无影响(P>0.05)。结论:围绝经期妇女使用IUD未增加月经改变、围绝经期症状、妇科疾病及贫血的发生,但不同种类IUD对围绝经期妇女月经异常有一定影响,应对围绝经期妇女与IUD种类的匹配情况做进一步研究。

Effect of intrauterine device on reproductive health during peri-menopausal period

Objective：To investigate the influence of intrauterine device （IUD）on reproductive health during peri-menopausal period. Methods： A stratified cluster random sampling method was used. A questionnaire survey and health examination was conducted in 615 women using IUDs （IUD group） and 538 with no use of IUD （control group） during peri-menopausal period. The data were analyzed with logistic multiple regression method. Results： The incidence of irregular menstrual cycle in the IUD group was lower than that in the control group. The prevalence of lumbago and abdominal pain in the IUD group was significantly higher than that of the control. The incidences of annexitis and myoma of uterus,or cervical hypertrophy in the IUD group were significantly higher than those of the control group. The effects on menstruation and dysmenorrhea were significantly decreased as time went on （P〈0.05）. The effects of different types of IUDs on menstrual cycle,amount and period of menstrual bleeding as well as dysmenorrheal were significantly different （P〈0.05）. There were no differences in amount and period of menstrual bleeding,hemoglobin level,and the occurrence rates of peri-menopausal symptoms and vaginitis（P〉0.05）. The multivariate analysis showed that the time of IUD insertion had no impact on menstrual cycle and amount of menstrual bleeding （P〉0.05）. Conclusion： The use of IUD during peri-menopausal period could not impact the properties of menstruation,and increase the incidences of peri-menopausal symptoms,gynecological diseases and anemia. Further study should be performed on personalized choice of IUD in women during peri-menopausal period.