重复性剖宫产术中放置吉娜宫内节育器80例的临床分析

Clinical analysis on placing Gyne Fix PP IUD in repeated cesarean section of 80 cases

目的探讨重复性剖宫产术中放置吉娜固定式宫内节育器（Gyne Fix PP IUD）的可行性及安全性,为瘢痕子宫妇女提供一种较好的避孕措施。方法选择2013年4月~2015年1月扬州大学附属医院扬州市妇幼保健院收治的重复性剖宫产术中放置Gyne Fix PP IUD的80例患者作为观察组,选择同期重复性剖宫产术中未放置节育器的患者80例作为对照组。观察两组手术时间、产后24 h出血量、产褥病率、抗生素使用时间、血性恶露持续时间及42 d复查子宫复旧情况;并进行1年随访,观察Gyne Fix PP IUD的续用率。结果两组手术时间、产后24 h出血量、产褥病率、抗生素使用时间、血性恶露持续时间比较,差异均无统计学意义（P〉0.05）。观察组随访期间,IUD脱落2例,IUD下移1例未取出在随访中,带器妊娠1例,异位妊娠2例,月经异常终止使用者1例,1年后续用率92.5%。结论重复性剖宫产术中放置Gyne Fix PP IUD,是一种简便、安全的避孕措施。

Objective To investigate the feasibility and security of placing Gyne Fix PP IUD in repeated cesarean section, and to provide a good contraception for women of scar uterus. Methods 80 cases of repeated cesarean section and placed Gyne Fix PP IUD from April 2013 to January 2015 in Yangzhou Maternal and Child Care Service Center,Yangzhou University Medical Academy Affiliated Hospital were selected as observation group, 80 cases of repeated cesarean section without IUD were selected as the control group at the same period. Operation time, 24 h postpartum bleeding amount, puerperalism, time of antibiotic use, hemorrhagic duration of lochia, and reexamination condition of uterine involution 42 d postpartum of two groups were compared; the continuation rate of Gyne Fix PP IUD was observed during the 1-year follow-up. Results There was no statistically significant difference in operation time, 24 h postpartum haemorrhage amount, puerperalism, time of antibiotic using, hemorrhagic duration of lochia between two groups（P 0.05）. During the follow-up, 2 cases of IUD fell off, 1 case of IUD move down but notbe taken out and in the follow-up,1 case with pregnancy, 2 cases of ectopic pregnancy, 1 case end use the IUD for abnormal menstruation. The continuation rate of Gyne Fix PP IUD was 92.5% in the after one year. Conclusion Placing Gyne Fix PP IUD on patients with repeated cesarean section, is a simple, safe contraceptive measures, and worth of recommend.