B超监测TCU380A宫内节育器434例临床观察

Influential factors for TCU380A intrauterine device function after insertion under B-type ultrasound guidance

目的利用B超监测放置TCU380A宫内节育器(intrauterine device,IUD)的过程,观察置器到位的IUD使用效果及影响效果的因素.方法选择18～40周岁健康育龄妇女,在B超监测下放置TCU380A IUD434例并测量相应数据,分别于置器后1、3、6、12、18个月行B超及妇科随访,记录受试对象生物学特征、术时、术后情况,以SPSS软件包进行数据分析和处理.结果①B超监测下置器无放置手术意外发生;置器后18个月累积带器妊娠率为1.94%(4/434),脱落率为4.59%(13/434),因症终止率为5.54%(13/434).②剖宫产、人流加上环史是影响脱落的危险因素(P＜0.05).③置器医生水平对IUD脱落有影响(P＜0.05).结论B超监测IUD的放置过程可确保将IUD放置到位,并可避免手术过程中的不安全隐患,是保证IUD放置效果的有效方法,值得在基层卫生和计划生育服务机构推行.

Objective To evaluate the clinical effect and influential factors of intrauterine device (IUD) after insertion under B-type ultrasound guidance. Methods A total of 434 healthy women of childbearing potential, aged for 18 to 40 years were enrolled. After IUD insertion under ultrasound guidance, the uterine profile was observed during the procedure and the patients’ biological characteristic was recorded and gynecologic examiation was performed at month 1, 3, 6, 12, 18 during following up. All data were analyzed with SPSS software. Results There was no accident in operation.In 18 months after IUD insertion, the pregnancy rate with IUD was 1.94%,the expulsion rate was 4.59% and the removal rate was 5.54%. The risk factors of expulsion were the history with cesarean delivery and artificial abortion plus IUD insertion (P<0.05) as well as the doctors’skills. Conclusion It is a way to guarantee IUD insertion under the guidance of B-type ultrasound and to avoid accident and ensure the IUD function, worth spreading in the basic unites of health and family planning.