绝经后妇女宫内节育器去留的安全性研究

The Safety of IUD Situ after Manopause.

我国带器进入绝经期的妇女日益增多,其中有相当一部份妇女在绝经后未能将宫内节育器(IUD)及时取出。绝经后IUD长期留在体内是否安全?以往小样本预调查结果提示:绝经后未取IUD者健康情况和宫腔细菌涂片与对照组无明显差异。本课题采用较大样本,对上海、青岛、济南等地843例绝经后未取IUD妇女和890例无IUD妇女进行健康状况、劳动力情况调查,同时进行妇科病普查和宫腔分泌物检查。结果:有IUD组的平均年龄、孕产次、职业、月经初潮年龄以及绝经前的全身情况与对照组(无IUD)对象状况均相似,有IUD组IUD在宫内平均存放20年以上,绝经后IUD留在宫内平均8年以上,未发现宫腔积脓、严重盆腔炎。宫腔分泌物细菌培养和直接涂片检查两组细菌检出率相似,各为18.9％与19.1％。绝经后未取IUD组子宫、宫颈、阴道萎缩均迟于对照组。有IUD组对象的健康状况与劳动力情况均与对照组相似。提示绝经后尚未取出IUD妇女,如无腹痛、出血等症状,IUD长期留在宫内对健康无明显不利的影响。本研究得出,绝经不满2年者,取器顺利比例达96.1％,超过2年以上者,取器困难达43.9％。建议绝经1年以内最好取出IUD。如绝经年限较长,无临床症状者,应定期随访,可以不取IUD。

Objective:To investigate the safety of IUD in the uterus for a long duration in women after menopause. Methods:The study was carried out during gynecological survey. Among 1 733 post menopause women, 843 cases still had their IUDs in situ and 890 cases had no IUDs. The histories and pelvic examination and bacteria counts in menopause women revealed the following results: Becteria counts in IUD group were similar to those in the control. The health and labour force in IUD group were similar to the control. No endometrial or cervical carcinomas were found in both groups. Conclusions: No significant harm been found in those postmenopausal cases, where IUDs were retained for a long time. If there was no clinical symptoms and was difficult remove, the wearers could be kept under cloze follow up for longer time.