600例大官腔放置吉妮致美宫内节育器的临床效果观察

目的探讨宫颈口松弛、宫内节育器宫内节育器（intrauterine contraceptive device, IUD）脱器史、宫腔较大者，使用吉妮致美（Indomethacin—GyneFix）的临床效果。方法将2004年1月至2005年12月600例在本中心经超声监测下放置吉妮致美宫内节育器妇女（无放置宫内节育器禁忌证）按照官腔深度分为两组，宫腔深度为（6～9）Cm纳人I组（n=329），〉9cm纳入Ⅱ组（n=271）（本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准，得到该委员会批准，分组征得受试对象本人的知情同意，并与之签署临床研究知情同意书）。统计不同宫腔深度放置吉妮致美宫内节育器36个月的累计脱落率、带器妊娠率及续用率，随访时间为置器后的1，3，6，12个月及以后每年1次直至3年。结果I组36个月吉妮致美宫内节育器累计脱落率为0．6％，Ⅱ组为0．7％，两组比较，差异无显著意义（P〉0．05）；带器妊娠率和续用率两组比较，差异无显著意义（P〉O．05）。结论吉妮致美宫内节育器可作为宫腔较大、宫颈口松弛、有脱器史妇女的避孕选择。

Clinical Observation on the Effect of Indomethacin-GyneFix-Intrauterine Contraceptive Device of 600 Cases With Huge Uterine Cavity

Objective To discuss the clinical effects of Indomethacin-GyneFi- intrauterine contraceptive device（IUD） on patients with relaxation of cervix, intrauterine contraceptive device dropped, and huge uterine cavity. Methods From January 2004 to December 2005, 600 women underwent Bultrasound monitor of inserting the Indomethacin-GyneFi-IUD without contraindication of using intrauterine contraceptive device were divided into two groups according to the depth of uterine cavity： Group I （n= 329） with uterus depth of （6-9）cm, group Ⅱ （n=271） with uterus depth more than 9 cm. Informed consent was obtained from all patients. The cumulative expulsion rates in the 36 months, pregnancy rate with Indomethacin-GyneFi-IUD and reuse rate were statistically analyzed. The follow up time were the first month, third month, sixth month, twelfth month after placing the Indomethacin-GyneFix-IUD, after that, patients should follow up once a year. Results The total desquamation rates of Indomethacin- GyneFix-IUD were 0.6% for group I and 0.7% for group Ⅱ during the next 36 months after the operation. There were no significant difference between two groups （P〉 0. 05）. Pregnancy rate with Indomethacin- GyneFix-IUD and reuse rate also had no significant difference （P〉 0. 05）. Conclusion Indomethacin- GyneFix-IUD can be used as a contraception method for women with huge uterine cavity, relaxation of cervix, or annulus dropped.