曼月乐对育龄期妇女的节育效果及安全性分析

The contraceptive effect and safety analysis of Mirena for childbearing women

目的探讨左炔诺孕酮宫内节育系统(曼月乐)对育龄期妇女的节育效果及安全性。方法随机选取我院育龄期要求节育妇女165例作为研究对象,根据采用不同的节育器系统将患者分为两组,研究组(85例)采用曼月乐节育器,对照组(80例)采用宫铜节育器,组间比较节育效果和不良反应状况。结果研究组带器妊娠率、脱环率稍低于对照组,避孕成功率稍高于对照组,但两组比较差异无统计学意义(P>0.05),两组闭经、绝经期综合征和疲乏率比较差异亦无统计学意义(P>0.05),但研究组副作用(月经量增多、不规则子宫出血和下腹痛)发生率均明显低于对照组,月经量评分、痛经程度评分和子宫内膜厚度均明显低于对照组,两组比较差异具有显著性(P<0.05),血清促血管生成素-1、基质金属蛋白酶9和血管内皮生长因子(VEGF)水平显著低于对照组,满意率明显高于对照组,两组比较具有明显差异(P<0.05)。结论宫铜与曼月乐节育效果相当,但与传统宫铜节育器相比,曼月乐通过降低子宫内膜相关因子的释放以减轻置入节育器后子宫异常出血、疼痛等副作用,提高节育满意率。

Objective： To investigate the contraceptive effect and safety analysis of Mirena for childbearing women.Methods： 165 cases of childbearing women required contraception were randomly selected as research subjects,and according to different IUD systems,all were divided into the two groups,with study group（ 85 cases） given Mirena intrauterine device,and the control group（ 80 cases） by uterus copper IUD,and contraceptive effect and adverse reaction conditions were compared between the groups. Results： Pregnancy and removal ring rate of the study group were slightly lower than those of the control group,contraception success rate was slightly higher than that of the control group,but it had no statistically significant difference between the two groups（ P〈0. 05）,Amenorrhea,menopausal syndrome and fatigue rate between groups had no statistically significant differences（ P〈0. 05）,but the side effects rates（ menorrhagia,irregular uterine bleeding,and abdominal pain） of study group were significantly lower than those of the control group,menstrual quantity scores,dysmenorrhea degree score and endometrial thickness were significantly lower than that of the control group,which had significant difference between the two groups（ P〈0. 05）,the levels of serum angiopoietin-1,matrix metalloproteinase 9 and vascular endothelial growth factor were significantly lower than those of the control group,satisfactory rate was significantly higher than that of the control group,which had significant difference between two groups（ P〈0. 05）. Conclusion： The uterus copper and Mirena contraceptive have quite good efficacy,but compared with uterus copper IUD,Mirena reduces side effects of abnormal uterine bleeding,pain after insertion IUD contraception by reducing endometrial related factor release,which improves the satisfaction rate.