放置宫内节育器对输卵管阻塞性不孕的影响

The affects of placement of intrauterine device on the incidence of fallopian tube obstruction

目的探讨放置宫内节育器(IUD)是否增加输卵管阻塞性不孕的发生率。方法选择2014年1月—2015年12月沈阳市计划生育科学研究所继发性不孕患者458例为观察人群,以既往使用IUD、取出后未孕的246例为IUD组,无IUD使用史的212例为对照组。根据2组病史、白带常规、支原体(UU)、衣原体(CT)、盆腔B超及输卵管造影(HSG)检查结果,综合分析放置IUD是否增加输卵管阻塞性不孕发生风险。结果 IUD组输卵管阻塞者较输卵管通畅者生殖道感染发生率高(盆腔炎:32.6%vs.15.7%;CT:23.9%vs.9.3%;UU:42.8%vs.18.5%;阴道炎:36.2%vs.24.1%;均P<0.05)。IUD组中,输卵管阻塞占56.1%(138/246),对照组中输卵管阻塞占63.7%(135/212),2组输卵管阻塞发生率差异无统计学意义(P>0.05);2组输卵管阻塞者的宫腔操作史和生殖道感染发生率差异无统计学意义(宫腔操作史:55.8%vs.45.2%;盆腔炎:32.6%vs.39.3%;阴道炎:36.2%vs.34.1%;CT:23.9%vs.27.4%;UU:42.8%vs.40.7%;均P>0.05)。结论未发现放置IUD与输卵管阻塞存在必然联系,IUD不增加输卵管阻塞的发生率。

Objective To investigate whether the placement of intrauterine device（IUD） can increase the incidence offallopian tube obstruction. Methods A total of 458 patients with secondary infertility who visited the outpatient clinicbetween January 2014 and December 2015 were selected for observation group, of which, 246 cases who used IUD in thepast but were not pregnant were the IUD group, and 212 cases with no history of using IUD were the control group. Accordingto the medical history of two groups,and based on test results of gynecological routine inspection, mycoplasma（UU）,chlamydia（CT）, type B ultrasound examination of pelvic cavity and hysterosalpingography（HSG） in two groups, whether theplacement of IUD increased the risk of fallopian tube obstructive infertility was comprehensively analyzed. Results Therewas a higher incidence of reproduction tract infection in patients with fallopian tube obstruction than that in patients withoutfallopian tube obstruction in IUD group（pelvic infection 32.6% vs. 15.7%,CT 23.9% vs. 9.3%,UU 42.8% vs. 18.5%,vaginitis 36.2% vs. 24.1%,P〈0.05）. Results showed that 56.1%（138/248） patients were found fallopian tube obstruction inIUD group, and 63.7%（135/212） in control group. There was no significant difference between the two groups（P〉0.05）.There were no significant differences in history of uterine cavity operations and incidence of reproductive tract infectionbetween two groups of patients with tubal obstruction（uterine cavity operations 55.8% vs. 45.2%,pelvic infection 32.6% vs.39.3%,vaginitis 36.2% vs. 34.1%, CT 23.9% vs. 27.4%,UU 42.8% vs. 40.7%,P〉0.05）. Conclusion There is nonecessary correlation between fallopian tube obstruction and placement of IUD, which therefore will not increase theincidence of fallopian tube obstruction.