宫内节育器取出困难相关因素分析

Correlation factors analysis on difficult removal of intrauterine device

目的:分析宫内节育器(IUD)取出困难的相关因素。方法:选择980例取器妇女临床资料,分析取器年龄、有无人工流产史、妇科疾病史、置器和取器时机、IUD嵌顿、子宫位置与取器困难的关系。结果:取器困难组年龄高于取器容易组;取器困难者放置IUD年限较长;围绝经期发生取器困难的比例较高,嵌顿可能是造成取器困难的重要原因;子宫后位组取器困难的比例高于子宫前位或中位组;Logistic回归分析表明,取器时机[3.310(2.171,5.045)]、IUD嵌顿[77.078(40.631,146.220)]、子宫后位[2.212(1.358,3.602)],是取器困难的独立相关因素。结论:IUD嵌顿是取出IUD困难的主要危险因素;围绝经期妇女应尽早取器;取IUD时要注意子宫位置,尤其是前倾或后倾明显者。

Objective：To analyze the correlation factors of difficult removal of intrauterine device （IUD）.Methods：980 women with IUD removal were recruited into this study,and the clinical data were analyzed according to the age of IUD removal,history of induced abortion and gynecology disease,time of IUD placement ,IUD incarceration and the relationship between uterus location and difficult removal.Results：The age of the group with difficult removal was elder than that of the easy removal group.The ratios of difficult removal increased with the longer keeping time of IUD.The proportion of difficult removal was higher during perimenopausal period.And incarceration was the critical cause leading to difficult removal.The incidences of difficult removal in uterus retroposition group were higher than that in anteposition or meso -position of uterus. Logistic regression analysis showed that：time of IUD removal [3.310 （2.171,5.045）],IUD incarceration [77.078（40.631,146.220）] and uterus retroposition [2.212（1.358,3.602）] were independent correlation factors for difficult removal. Conclusion：IUD incarceration is the principal risk factor for difficult removal. And IUD removal should be performed as early as possible during peri-menopausal period. Even more attention should be paid to the uterus location,especially the obvious anteversion and retroversion.