流产术后皮下埋植与宫内节育器避孕临床观察

An observation on the contraceptive effect and adverse reactions of subcutaneous implantation and intrauterine device used immediately after abortion

目的:观察人工流产术后及时植入皮下埋植和宫内节育器(IUD)置入避孕效果及不良反应。方法:2014年2月-2016年2月本中心行人工流产术并有避孕需求的320例为研究对象,流产术后根据妇女意愿分为皮下埋植避孕(埋置剂组)或放置含铜IUD避孕(IUD组),每组各160例。随访2年,统计妊娠和避孕因症取出及不良反应。结果:埋植剂组帯器妊娠、脱落及因症取出等终止率(1.9%)均低于IUD组(9.5%)(P=0.006),续用率(95.1%)高于IUD组(86.9%)(P=0.008);阴道不规则出血和宫腔黏连发生率埋植剂组(5.0%、2.5%)与IUD组(6.3%和2.4%)无差异(P=0.627、0.410),且月经减少或闭经发生率埋植剂组(6.3%)高于IUD组(1.2%)(P=0.019),而经期紊乱、月经增多和腰腹疼痛发生率埋植剂组(6.9%、1.2%、1.9%)均低于IUD组(14.4%、5.6%、8.1%)(P=0.029,0.032、0.010)。结论:人工流产后行皮下埋植或IUD避孕均具有良好可靠的避孕效果和较高的续用率,且皮下埋植避孕不良反应较低,值得临床推广使用。

Objective:To observe the effect of timely subcutaneous implant and intrauterine device (IUD) used immediately after induced abortion.Methods:320 women with artificial abortion and contraceptive demand were selected as research subjects form February 2014 to February 2016,and divided into group A(160 women had received subcutaneous implantation immediately after induced abortion) and group B (160 women had received IUD containing copper inserted immediately after induced abortion).The rates of pregnancy,termination due to disease,and adverse reactions were compared between the two groups in 2 years followed up.Results:The termination rate due to pregnancy,removal,or disease of women (1.9%) in group A was significant lower than that of women(9.5%) in group B (P = 0.006),and the continuation rate of women (95.1%) in group A was significant higher than that of women (86.9%) in group B(P =0.008).The incidence of irregular vaginal bleeding and intrauterine adhesion of women (5.0% and 2.5%) in group A had no statistically significant different to those of women(6.3% and 2.4) in group B (P =0.679,0.410).The rate of menorrhagia and amenorrhea of women (6.3%)in group A was significant higher than that of women (1.2 %)in group B(P =0.019),while the incidences of menstrual disorder,menstrual increase or lumbar abdominal pain of women(6.9%,1.2% or 1.9%) in group A were significant lower than those of women(14.4%,5.6%,or 8.1 %) in group B (P =0.029,0.032,0.010).Conclusion:Subcutaneous implantation and IUD used immediately after abortion have both good contraceptive effect and higher continually used rate.The adverse reaction of subcutaneous implantation is lower,so it is worthy of clinical application.