吉妮与母体乐宫内节育器避孕效果及不良反应的比较

Comparison of contraceptive effects and adverse reactions of Gynifix and Mutile intrauterine devices

目的 比较两种宫内节育器（古妮和母体乐）在不同时期放置的避孕效果及不良反应。方法2000年6月至2002年6月，在240例自愿放置节育器者中，月经干净1—7d放置的116例；停经6—9周，行人工流产术的同时放置者64例；住采取紧急避孕措施的同时放置者60例。将3组再均分为观察组和对照组，观察组（共120例）放置吉妮环，对照组（共120例）放置母体乐，术后随访12个月。结果术后1个月时，吉妮组脱落率0．8％（1／120），母体乐组脱落率1．7％（2／120），两组差异无统计学意义（P〉0．05）；术后12个月时，吉妮组脱落率0．8％（1／120），母体乐组脱落率4．2％（5／120），之间差异仍无统计学意义（P〉0．05）。吉妮组妊娠率与母体乐组差异无统计学意义（分别为0．8％和1．7％，P〉0．05）。术后1个月和12个月时，两组出血及腹痛发生率比较差异均无统计学意义，因症节育器取出率差异亦无统计学意义（P〉0．05）。吉妮组的续用率97．5％（117／120），母体乐组续用率90．0％（108／120），之间差异有统计学意义（P〈0．05）。不同时期放置同种宫内节育器的脱落率、各组间妊娠率、因症取出率各组间差异均无统计学意义。结论 吉妮和母体乐宫内节育器在不同时期放置均安全有效，两种节育器的不良反应虽无统计学意义，但古妮组续用率明显高于母体乐组。

Objective To compare contraceptive effects and adverse reactions of Gynifix （Gyn） in intrauterine device （IUD） and Mutile （ML） IUD inserted at different periods of menstruation. Methods Two hundred and forty child-bearing age women with voluntary IDU insertion were involved in the study during June 2000 to June 2002, and IUDs were inserted in 116 of them one to seven days after menstruation, in 64 during their induced abortion performed due to amenorrhea for six to nine weeks, and in 60 at the same time as emergency contraceptive measures taken. All the 240 women were divided equally into observation and control groups, 120 women with Gynifix IUD, and the another 120 with ML IUD. All the subjects were followed up for 12 months after IDU insertion. Results One month after operation, expulsion rates was 0. 8% （1/120） in Gyn IUD group and 1.7% （2/120） in ML IU group, with no statistically significant difference （P 〉0.05）. Twelve months after IUD insertion, expulsion rates was 0.8% （1/120） in Gyn IUD group and 4.2% （5/120） in ML IUD group, still with no statistically significant difference （P 〉 0.05）. There was also no statistically significant difference in conception rate between women with Gyn IUD and ML IUD （0.8% vs 1.7%, P 〉0.05）. One month and 12 months after IUD insertion, there was no statistically significant difference in occurrence of relevant symptoms, including irregular uterine bleeding and lower ＇abdominal pain, between the two groups, as well as in IUD removal due to complications （P 〉 0. 05）. Retention rate was 97.5% （117/120） in Gyn IUD group and 90.0% （108/120） in ML IUD group, with statistically significant difference （ P 〈 0.05）. There also was no statistically significant difference in IUD expulsion, conception and IUD removal due to complications between women of the two group with IUD inserted at different periods of menstruation. Conclusions It is safe and effective for both Gyn and ML IUDs insertion at different periods of menstruation. No statistically significant difference in adverse reactions between women with the two IUDs was found. Retention rate for Gyn IUD was significantly higher than that for ML IUD.