生育女性人工流产后即时使用曼月乐的可接受性观察

Acceptability of levonorgestrel-releasing intrauterine system inserted post surgical abortion in parous women

目的 调查生育妇女在流产后使用左炔诺酮官内缓释系统（曼月乐）作为避孕方法的可接受性，并对人工流产后与经期上环后放置左炔诺酮官内缓释系统的出血模式进行观察分析。方法 在充分咨询下，使患者知情选择，并签署同意书后使用曼月乐，并在6周、3个月、6个月、12个月来门诊随访，并详细填写月经卡及调查问卷。结果 129例根据上环时机不同即分别于人工流产后上环和经期上环，分组为A组和B组，根据随机表随机在两组中抽样，A组抽取37例，B组抽取35例。随访期间，生育妇女使用曼月乐的可接受性为95．7％～100％，没有妊娠或脱落。出血模式改变的主诉多见，其他如头痛、腹痛、腰痛、乳痛、痤疮、体重增加、情绪影响、性生活受影响等比例少。观察人工流产后放置组的出血模式较经期放置组的好。结论 生育妇女人工流产后使用左炔诺酮官内缓释系统的接受良好，出血模式优于经期上环者组，但本研究结果尚需大样本的研究证实。

Objective To evaluate the acceptability of the LNG - IUS （Mirena） as contraception, when offered freely among the Chinese women after suction termination of first- trimester pregnancy, menstrual bleeding patterns after insertion of LNG- IUS postabortally and during the menstruation. Methods According to the WHO medical eligibility criteria for acceptors selection, a total of 129 women who chose the LNG -IUS were enrolled into the study during from Jan 2005 to May 2006. The women who chose to be inserted immediately after the first trimester pregnancy termination were registered in group A, while those who were chosed to be inserted within 7 days with the onset of menstruation were registered in group B. In these groups, randomized samplings, 37 women from group A and 35 women from group B to follow- up visit. All cases chose the LNG - IUS in a free choice. Resalts There were no pregnancy, removal and serious complications. The acceptability of LNG- IUS after surgery abortion was high （95.7%- 100%） during the follow-up visit. All the subjects continued with the LNG- IUS for contraception. Bleeding changes were the most common complain. Postabortal insertion of LNG - IUS was associated with better pattern of bleeding than the insertion during the menstruation. Conclusions The LNG - IUS as a option of post - abortion - contraception freely were well - accepted by the Chinese women, and have better bleeding patterns. However, the study was a prospective observational clinic trial. The small sample size is the limitation of this study.