瘢痕子宫放置吉妮环的临床观察

Clinical observation of Gini ring placed in scarred uterus

目的观察瘢痕子宫妇女放置吉妮环的临床效果。方法 90例自愿上环的育龄妇女,其中30例放置吉妮环的瘢痕子宫妇女作为观察组A, 30例放置圆环的瘢痕子宫妇女作为观察组B, 30例放置吉妮环的健康育龄妇女作为观察组C,分别于放置后的3、6、9、12个月进行随访观察。比较三组妇女的宫颈扩张效果及观察组A、B上环1年后的随访情况。结果观察组A宫颈扩张总有效率为76.7%,观察组B宫颈扩张总有效率为76.7%,观察组C宫颈扩张总有效率为96.7%。观察组A与观察组B的宫颈扩张总有效率比较差异无统计学意义(χ~2=0, P=1>0.05)。而观察组C的宫颈扩张总有效率明显高于观察组A、观察组B,差异均有统计学意义(χ~2=5.1923、5.1923, P=0.0227、0.0227<0.05)。观察组A、观察组B患者上环后均完成1年随访。观察组A的脱落、妊娠、出血发生率分别为3.3%、0、3.3%,均明显低于观察组B的20.0%、13.3%、23.3%,差异均有统计学意义(χ~2=4.0431、4.2857、5.1923, P=0.0444、0.0384、0.0227<0.05)。结论瘢痕子宫患者放置吉妮环较健康育龄妇女难度增加,但较瘢痕子宫患者放置圆环的避孕效果更好,脱落率更低,出血发生率更低,值得用于瘢痕子宫放环的临床推广。

Objective To observe the clinical effect of Gini ring placed in maternal women with scarred uterus.Methods A total of 90 fertile woman with voluntary rings,including 30 scar uterus women placed with Gini ring as observation group A,30 car uterus women placed with ring as observation group B,and 30 healthy fertile women placed with Gini ring as observation group C.Follow-up observation was carried out at 3,6,9 and 12 months after placement.Comparison were made on the effect of cervical dilatation of three groups and follow-up of observation group A and B after 1 year of ring placement.Results The observation group A had total effective rate of cervical dilatation as 76.7%,which was 76.7%in observation group B and 96.7%in observation group C.Observation group A and observation group B had no statistically significant difference(χ^2=0,P=1>0.05).Observation group C had obviously higher total effective rate of cervical dilatation than observation group A and observation group B,and their difference was statistically significant(χ^2=5.1923,5.1923,P=0.0227,0.0227<0.05).All patients in observation group A and observation group B were followed up for one year after ring placement.Observation group A had obviously lower incidence of abscission,pregnancy and bleeding respectively as 3.3%,0 and 3.3%than 20.0%,13.3%and 23.3%in observation group B,and the difference was statistically significant(χ^2=4.0431,4.2857,5.1923,P=0.0444,0.0384,0.0227<0.05).Conclusion Gini ring placement in scarred uterus is more difficult than that in healthy fertile women,but it has better contraceptive effect of lower dropping rate and lower bleeding rate than that in scarred uterus.It is worthy of clinical promotion for scarred uterus ring placement.