计划生育手术后即时放置左炔诺孕酮宫内节育系统在瘢痕子宫妇女中的应用效果

Application effect of immediate placement of levonorgestrel intrauterine system after family planning surgery in women with scar uterus

目的分析计划生育手术后即时放置左炔诺孕酮宫内节育系统在瘢痕子宫妇女中的应用效果。方法回顾性分析我院2015年2月至2016年12月进行计划生育手术的68例瘢痕子宫妇女的临床资料,根据放置节育器的不同分为对照组和观察组,各34例。对照组放置含铜节育器,观察组放置左炔诺孕酮宫内节育系统,观察并比较两组妇女的使用效果。结果置入12个月时,观察组的经期延长或缩短、经量增多发生率均明显低于置入1个月时(P<0.05),但不规则出血、腰背腹痛及白带增多发生率与置入1个月时无明显差异(P>0.05);置入12个月时,对照组的各项不良反应发生率较置入1个月时虽有减少,但无明显差异(P>0.05);两组置入1年内各个时期的不良反应发生率均无明显差异(P>0.05)。置入1周后,观察组的IL-6、IL-10、TNF-α水平低于对照组(P<0.05)。置入1年内,观察组的终止使用率明显低于对照组(P<0.05)。结论计划生育手术后即时放置左炔诺孕酮宫内节育系统在瘢痕子宫妇女中的临床效果显著,能有效降低放置节育器后的血清炎性因子水平,降低终止使用率,且随着时间的延长,能有效减少经期延长或缩短以及经量增多的情况,安全可靠,值得临床应用。

Objective To analyze the application effect of immediate placement of levonorgestrel intrauterine system after family planning surgery in women with scar uterus.Methods The clinical data of 68 women with scarred uterus who underwent family planning surgery from February 2015 to December 2016 in our hospital were retrospectively analyzed,and the women were divided into control group and observation group by different placed contraceptive devices,with 34 cases in each group.The control group was placed with copper contraceptive device,and the observation group was placed with levonorgestrel intrauterine system,and the using effects of the two groups were observed and compared.Results At 12 months of implantation,the incidences of prolonged or shortened menstrual period and increased menstrual volume in the observation group were significantly lower than those at 1 month of implantation(P<0.05),however,there were no significant differences in the incidences of irregular bleeding,low back and abdominal pain and leucorrhea between the two groups at 1 month of implantation(P>0.05);at 12 months of implantation,the incidences of adverse reactions in the control group were lower than those at 1 month of implantation,but there were no significant differences(P>0.05);there were no significant differences in the incidences of adverse reactions between the two groups in each period within 1 year of implantation(P>0.05).After one week of implantation,the levels of IL-6,IL-10 and TNF-αin the observation group were lower than those in the control group(P<0.05).Within one year of implantation,the termination using rate in the observation group was significantly lower than that in the control group(P<0.05).Conclusion Immediate placement of levonorgestrel intrauterine system after family planning surgery in women with scar uterus has a significant clinical effect,it can effectively reduce the serum inflammatory factors levels after placing contraceptive device and the termination using rate.With the extension of time,it can effectively reduce the situation of prolonged or shortened menstrual period and increased menstrual volume,which is safe and reliable,and is worthy of clinical application.