放置IUD后宫腔微生物及子宫内膜病理学研究

Detection of intrauterine microorganism and endometrium pathology of women using in - trauterine device

研究ＩＵＤ与盆腔感染及子宫内膜恶变或其他病理改变的关系，探讨 ＩＵＤ长期使用的安全性。方法：将 ８８例分为 Ａ、Ｂ、Ｃ、Ｄ ４组，Ａ组 ２０例使用带尾丝活性 ＩＵＤ；Ｂ组２４例使用惰性 ＩＵＤ；Ｃ组 ２４例为正常对照组；Ｄ组 ２０例为盆腔感染组。所有病例取宫腔冲洗液进行需氧菌、厌养菌、解脲支原体、沙眼衣原体等培养，并取子宫内膜进行病理学检查，结果：Ａ、Ｂ组主要表现为正常增生期、分泌期或月经期子宫内膜，部分是单纯性或腺囊性增生，与Ｃ组、Ｄ组差异无显著性（Ｐ＞０．０５），４组均未见不典型增生及恶变。Ａ、Ｂ、Ｃ３组子宫内膜均无慢性炎症改变，Ｄ组８例存在慢性子宫内膜炎改变，与Ａ、Ｂ、Ｃ组差异有显著性（Ｐ＜０．０５）。Ａ、Ｂ、Ｃ组淋巴细胞、浆细胞、中性白细胞、纤维细胞计数差异无显著性（Ｐ＞０．０５），Ｄ组淋巴细胞、浆细胞、中性白细胞计数较以上３组明显增加（Ｐ＜０．０５），间质细胞及纤维细胞计数与以上３组差异无显著性（Ｐ＞０．０５）。Ａ、Ｂ、Ｃ组宫腔微生物检出率分别为３０．０％，２９．２％，２０．８％，与Ｄ组（７０．０％）差异有显著性（Ｐ＜０．０５）。结论：使用ＩＵＤ５－１４年未增加子宫内膜癌、癌前病变及慢性子宫内膜炎发生率。

Objective:To study the relationship between IUD and pelvic infection or the pathological changes of endometrium. Methods: Eighty - eight cases were divided into four groups. A:twenty cases were using active tailed IUD; B: twenty - four cases were using inert IUD;C: twenty - four cases were control group; D: twenty cases were pelvic infection group. The microorganisms of the uterine flushing were detected and the endometria were studied for pathology. Results:The stages of endometrium were not different (P > 0.05 ) and there were not atypical hyperplasia or malignant in four groups. There was no case with chronic endometritis in A,B,C groups, but there were eight cases with chronic endometritis in D group(P < 0.05). The numbers of inflammatory cells were not significantly different among A, B and C (P > 0.05),but there were significantly difference between A. B or C and D. The numbers of fi- brocyte and stromal cells were not significantly different among A, B, C and D. The rate of microoganisms were significantly different between A(30. 0% ), B(29. 2% ) or C(20. 8% ) and D(70.0% ). Conclusions:The risk of endometrial carcinoma or chronic endometritis were not increased for women using IUD for 5 - 14 years. So it is safe for women using IUD for long term.