我国绝经后妇女宫内节育器取出问题综述

A review on removal of intrauterine device in postmenopausal women in China

目的探讨国内围绝经期妇女宫内节育器(intrauterine device,IUD)滞留现状、可能造成的健康问题以及取出困难情况。方法在CNKI、万方、CBM、PubMed等中外数据库中检索了迄今为止我国与围绝经期及绝经后IUD取出相关的公开发表文献,获得了符合本综述纳入排除标准的15篇相关研究,并对其进行质量评价和结果整理。结果纳入研究普遍提到IUD滞留问题。IUD取出难度及妇女的心理问题均随妇女绝经时间的增加而增大。围绝经期IUD滞留与腰部疼痛、小腹坠痛和绝经后出血有关。绝经后适时取出IUD有助于改善妇女腰背疼痛、心理问题的发生,能够有效避免后期IUD取出困难问题。结论围绝经期妇女存在IUD滞留问题,IUD滞留可能造成取出困难,同时可能造成妇女产生一系列生理、心理健康问题。因此,绝经后适时取出IUD作为生殖健康和计划生育持续服务问题亟待解决。

Objective Explore the retention situation,possible health problems,and difficulties in removal of intrauterine device(IUD)in women who are perimenopausal in China.Methods We have searched published literature related to IUD removal of perimenopausal and postmenopausal women in China from databases including CNKI,WanFang data,CBM,PubMed and other Chinese and foreign databases.Totaly fifteen studies were included according the criteria of study inclusion and exclusion and these studies were assessed the quality and their results were summarized.Results The mentioned problems of IUD retention were the difficulty of IUD removal and psychological problems with the increase of women's menopause time.At the same time,perimenopausal IUD retention is associated with back pain,low abdominal pain and postmenopausal bleeding.Timely and safely removal of IUD after menopause can help to release the back pain and psychological problems in women,and can effectively avoid the difficulty of IUD removal in the later period.Conclusion Perimenopausal women may have IUD retention.This problem may not only cause difficulties of IUD removal,but also cause a series of women's mental health issues.Timely removal of IUD after menopause is a urgent needs f for reproductive health and family planning ongoing services.