人工流产后即时放置曼月乐的临床观察

目的 观察早孕人工流产后即时放置与月经后期放置左炔诺孕酮宫内缓释系统(曼月乐)的避孕效果、不良反应比较.方法 166例自愿选择放置曼月乐的已生育女性,分人工流产术后即时放置组(观察组)86例和月经后期放置组(对照组)80例,随访12个月,对其避孕效果、续用率及不良反应进行观察比较.结果 观察组与对照组的妊娠率均为0,脱环率均为0,续用率分别为100％、95％,两组比较差异无统计学意义(P＞0.05),放置后3个月内点滴出血的发生率观察组为27.5％,对照组36.2％,两组比较差异有统计学意义(P＜0.05);1年内闭经分别为23.3％(20/86)、23.8％(18/76),两组比较差异无统计学意义(P＞0.05);其他不良反应如体重增加、痤疮、下腹胀、乳胀等的发生率低,两组相比差异无统计学意义(P＞0.05).结论 早孕人工流产后即时放置曼月乐,术后3个月点滴出血的发生率明显少于月经后期放置.曼月乐在人工流产术后即时放置与月经后放置具有相同的避孕效果,减少了点滴出血的发生,避免了2次宫腔操作.

Clinic observation of a levonorgestrel-releasing intrauterine system inserted immediately after artificial abortion

Objective To compare the contraceptive efficacies and side effects of Mirena (levonorgestrel-releasing intrauterine system,LNG-IUS)inserted immediately after artificial abortion and in the period of regular menstruation.Methods A total of 166 female subjects volunteered for the insertion of LNG-IUS.They were divided into 2 groups.Eighty-six female subjects inserted right after artificial abortion were selected as the observation group and 80 female subjects inserted during the period of regular menstruation as the control group.Follow-up was performed at one year after insertion.Contraceptive efficacies and side effects were compared between two groups.Results No pregnancy was found in both groups.No mirena expulsion occurred in neither groups.The continuation rates were 100％ and 95％ in the observation and control groups respectively(P ＞0.05).The rates of abnormal hemorrhage were 27.5％ and 36.2％ in observation and control groups respectively during the first three months(P ＜0.05).And 22.7％ and 23.3％ subjects suffered amenorrhea respectively in the first year.No significant difference was found in such side effects as amenorrhea,weight gain,acne and swollen breasts between two groups(P ＞ 0.05).Conclusion Mirena is proved to be an excellent choice for contraception after artificial abortion.Secondary intrauterine surgery may be avoided.And its insertions immediately after artificial abortion or during the period of regular menstruation share the same efficacies.