Norplant皮下埋植剂长期使用的有效性临床研究—八年经验

上海医科大学妇产科医院于１９８４年１０月至１９９３年１２月应用Ｎｏｒｐｌａｎｔ皮下埋植剂１６５７例（其中Ｎｏｒｐｌａｎｔ—Ⅰ型１３５６例，Ｎｏｒｐｌａｎｔ－Ⅱ３０１例）控制生育。１、３、５、６、７、８年的累积妊娠率分别为０、０．１、０．９、１．７、２．６、和３．３／１００妇女；妊娠率与最初埋植时的体重有关，体重重者妊娠率高。持续使用率分别为９７．１、８２．２、７３．５、４４．７、３４．３和１８．５／１００妇女。主要副反应为月经失调，是终止使用的主要原因；但总失血量不多，随着使用时间的延长，月经失调副反应逐渐减少。埋植剂的放置和取出技术易于掌握，在１６５７例使用中，未发生感染或其他并发症，使用安全。由于其妊娠率低，和不可能脱落及其高度可逆性，深为受术者欢迎。

A Clinical Study on the Long-term Use-effectiveness of Norplant Implants in Shanghai,China-8 year Experience

A study on Norplant implantation conducted in affiliated hospital of the Shanghai Medical University has so far dealt with the largest number of cases and the longest time-period of Norplant used at a single clinic in the world. A total of 1657 women,who had initial Norplant implantation from 1984 to 1987,were followed-up annually until the end of 1993, with extremely low rates of lost to follow-up life-table cumulative rates of continuation for all initial users at the end of lst.3rd and 5th years of use were 97. 1 % .82. 2% and 73. 5 %,respectively. The cumulative pregnancy rate at the end of the 5th、6th、7th and 8th years of use were 0. 9. 1. 7.2. 6 and 3. 3% ;these rates were higher for the users with heavier body-weights. Removal rates and specific reasons for removal were also observed. The proportion having complaints of menstrual disturbances reached 73% at the 3rd month of use but consistently dropped,to 18 % at 5 years of use ;and 14%at 8 years of use ;these proportions were further analyzed by age and body-weight of users. The body-weight,blood pressures,and levels of hemogolbin and blood levonorgestrel levers over several years of Norplant use were also compared.