放置含铜宫内节育器的五年临床观察

Multiload Cu250 IUD and VCu200 IUD forwomen with previous failure of stainless steel ring IUD: a 5-year randomized clinical trial

对２００例放置金属宫内节育器（ＩＵＤ）失败的妇女，随机放置含铜ＭｕｌｔｉｌｏａｄＣｕ２５０ＩＵＤ（ＭＬＣｕ２５０）和ＶＣｕ２００ＩＵＤ（ＶＣｕ２００）各１００例。临床观察５年，随访率９７．５％。结果表明：ＭＬＣｕ２５０和ＶＣｕ２Ｏ０的５年累积脱落率为１．０／每百妇女（下同）、８．１；妊娠率为１２．０、４．１；因出血和疼痛取出率为６．０、６．１；继续存放率为８０．０、８１．７。ＭＬＣｕ２５０脱落率明显低于ＶＣｕ２００，两者比较，差异有非常显著意义。提示：ＭＬＣｕ２５０和ＣＶｕ２００５年存放率高，避孕效果好，两种ＩＵＤ均适合于放置金属ＩＵＤ失败者。ＭＬＣｕ２５０至少可使用５年，如增加其铜表面积，有可能使妊娠率进一步降低。

wo hundred rural woinen with history of stainless steel ring (SSR) intrauterinc dcvices (IUD) failure(i.e. expulsion or pregnancy with IUD-in-aitu) wererandomly allocatal into Multiload Cu250 (MLCu250)or VCu200 group. The follow up rate was 97.5% atthe end of 5-year. The 5-year grosa cuniulativc con-tinuation rates per 100 women for MLCu250 andVCu200 were 80.0 and 81.7 respotively. Tbe 5-yearcumulative expulsion rate was significantiy lower inMLCu250 group (1.0) than that in VCu200 group(8.1) (p < 0.05), whilc the pregnancy rate was higlier inMLCu group (12.0 vs. 4.1) but no statistical signifi-cant differenor ealsted between the 2 groups. The re-moval for bleeding and (or) pain were sumilar (6.0 and6.1). Tbere was onc ectopic pregnancy in eacb groupand no removal for medical or personal rebons. Theexpulsion aud pregnancy cascs in tbc present studywere not associated with their previous failures. It wasconcluded that both types of copper IUD were effec-tive for women with previous failure of SSR. Thestudy also showed that MLCu250 night be used aslong as 5 years. Should surface area of copper be in-creased, further decreased pregnancy rate would beexpected.