600例停用宫内节育器妇女子宫内膜细胞学分析

Analysis of the disabling IUD women endometrial cytology of 600 cases

目的:了解多种宫内节育器(intrauterine devise,IUD)在不同情况下对子宫内膜细胞状态的影响。方法:在取出IUD时经同意采集子宫内膜组织制片,样本集中寄往北京大学附属医院妇产科"宫腔细胞学检测中心"阅片。结果:600例停用IUD妇女中,因症停用人群子宫内膜细胞非典型增生性改变、良性增生性改变的发生率明显高于无症停用人群,差异有统计学意义(P<0.05)。母体乐IUD良性增生性改变发生率明显高,其他IUD类型间差异无统计学意义(P>0.05)。非典型增生性改变的发生率与IUD放置时间有关,<1年的人群发生率明显高于1～5年及>5年的人群,差异有统计学意义(P<0.05)。结论:放置IUD后子宫异常出血等不良反应人群常常伴有子宫内膜良性增生及非典型增生性改变,与异物在子宫内膜表面的局部摩擦损伤有关,含吲哚美辛IUD有减轻这种反应的作用,铜离子可以加重其反应。放置IUD时选择合适的类型及大小,或者放置IUD前子宫内膜取样检测了解子宫内膜状态,选择性放置IUD以降低带器后不良反应的发生率。

Objective ： To understand the effect of variety of intrauterine device （IUD） on the endometrial cell state in different circumstances. Methods： After removal of IUD and agreed to take endometrial tissue production, concentrated samples were sent to Peking University Affiliated Hospital of Obstetrics and Gynecology ＂uterine cytology test center ＂ reader. Results ： Among 600 cases of disabling the IUD women, there were significant differences in the incidence of endometrial endometrial cell atypical hyperplastic changes and benign hy- perplastic changes between with and without symptoms disabled crowd. Benign hyperplastic change rate in mutile IUD was higher, there were no significant differences among other types of IUD. Atypical hyperplastic change rate was related with IUD placed time, rate of less than 1 years was higher than that of 1 - 5 years and 〉 5 years group, there was significant difference. Conclusion ： After IUD placement of abnormal uterine bleeding and side reaction of the crowd are often accompanied by endometrial hyperplasia and atypical hyperplasia of the change. With relevant foreign body injmy, the local endometrial surface, containing endomethacin IUD mitigate such reaction and copper ions can increase its reaction. Placing IUD in selecting the appropriate IUD type and size, or placed before IUD endometrial sampling detection about endometrial condition, selectively placed IUD, in order to reduce the belt for reaction rate.