A Multicentre Comparative Clinical Study of Three Types of IUD （Eight－Year Follow up）

The Stainless steel ring(SSR),VCu200 and TCu220C were ic randomized comparison for eight years in a cohort of 4,490 subjects covering 16 centres in 9 provinces andmunicipalities.The follow-up rate at the end of the eithth year was 90.33%.The cumulative continuation rates were 47.06 per 100 women at the end of foe eighth year for SSR,54.05 for VCu200 and 61.14 for TCu220C.The cumulative pregnancy rates for VCu200and TCu220C were 10.35 and 8.94 per 100 women respectively,significantly lower than24.14 for SSR. There were significant differences in eight-year expulsion rates amongSSR(21.69%),VCu200(13.05%)and TCu220C(7.48%).The removal for bleedingand/or pain was the lowest in SSR;and no signaificant differences were found betweenVCu200 and TCu200C.but foe rate ws getting higher in VCu200 at the end of the eighthyear than in TCu220C.The discontinued use of IUD for desire to become pregnant in rural area was extremely higher than in urban area. The risk of pregnancy and expulsionwas in association with the types of IUD in this study,age at insertion,previous use ofIUD and pregnancy frequency prior to insertion. The risk of pregnancy and expulsion forVCu200 and TCu220C was significantly lower than that for SSR. Failure risks were associated with age at insertion, the types of IUD in this study and pregnancy frequencyprior to insertion,and failure risk in SSR was still higher than in VCu200 and TCu220Cat the end of the eighth year. The study revealed that TCu220C was of good long-termsafety,efficacy,and acceptability.

三种国产宫内节育器临床多中心比较性研究（十年随访总结）

在全国９省市１７个中心，对不锈钢金属单环（金单），ＶＣｕ２００及ＴＣｕ２００ｃ三种宫内节育器进行随机临床多中心比较性研究。自１９８３年７月１日至１９８４年３月３１日共收集５０９０例。第１０年末的随访率为９１．２６％。ＴＣｕ２２０ｃ第１０年末每百妇女累积续用率为５６．７４，显著地高于金单（４４．７７）和ＶＣｕ２００（４４．５６）。ＴＣｕ２２０ｃ和ＶＣｕ２００的累积妊娠率分别为每百妇女９．６９和１０．７０，显著地低于金单的２３．４７。第１０年末时，金单的累积脱落率为２１．７９％，ＶＣｕ２００为１６．４８％，ＴＣｕ２２０ｃ为８．２８％，三种宫内节育器间存在显著性差异。因出血和／或疼痛取器，金单最低；从第７年开始，ＶＣｕ２００因出血和／或疼痛取器逐渐高于ＴＣｕ２２０ｃ，到第１０年末时其间显示出显著性差异，取出的ＶＣｕ２００中发现有些已散架成铜丝剥落。ＶＣｕ２００组自第５年起，因个人原因取器分别显著地高于金单和ＴＣｕ２２０ｃ，变换避孕方法者比以前增多，变换避孕方法的要求主要来自使用者，取器时发现有的无几丝，Ｘ光或Ｂ起检查发现有些器已变形。农村因要求妊娠而取器者极为显著地高于城市地区。建议ＶＣｕ２００的使用期限可定为５?

三种国产宫内节育器临床多中心比较性研究——(五年随访总结)

全国13省市共23个单位,对不锈钢金属单环、V Cu200及T Cu220c三种宫内节育器(IUD)进行随机临床多中心比较性研究。自1987年7月1日至1984年3月31日共接受对象6236例。五年末随访率为96.0%。60个月时每百妇女累积续用率以金单为最低,55.8%,V Cu及T Cu各为68.8%及72.4%。V Cu和T Cu的妊娠率分别为7.32%和7.24%,显著地低于金单的20.2%。60个月时金单、V Cu和T Cu的脱落率分别为19.0%、9.7%和5.6%,三者间呈显著性差异。因出血和/或疼痛取出率以金单为最低,二种带铜宫内节育器间无差别。三种IUD使用情况城市与农村间比较,城市的累积续用率均高于农村;妊娠、脱落和个人原因停用农村均高于城市。用Cox比例危险模型和似然比检验,发现金单的失败危险与以下因素有关:年龄、过去IUD使用史、劳动姿态、孕次和宫腔深度;前四个因素对VCu失败危险有影响;TCu失败危险除与前三个因有关外,哺乳期放器对其失败危险亦有影响。年龄和孕次均影响三种IUD的妊娠危险;过去IUD使用史分别作用于金单和VCu;宫腔深度分别影响金单和TCu的妊娠。T Cu的脱落仅受哺乳期放器影响;年龄、孕次、过去IUD使用史影响着VCu的脱落;金单脱落除上述三因素外,还受宫腔深度的影响,且前三个因素均呈极显著性差异。