固定式与支架式宫内节育器的有效性、安全性和续用率比较

Comparison of effectiveness,safety and continuation rate of the fixed versus the stented intrauterine devices

滕英 ¹陈星 ²岳茗肖 ¹武冰雪 ²黄蔚 ¹丁璟 ²秦明 ¹车焱 ²张妍²

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作者信息

1. 广西壮族自治区计划生育药具和医疗器械管理服务中心(南宁,530028)
2. 上海市生物医药技术研究院,国家卫生健康委员会计划生育药具重点实验室,复旦大学
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摘要

目的:观察固定式宫内节育器(IUD)在育龄女性中的安全性、有效性和续用情况.方法:以2022年1-6月使用国家免费IUD的育龄妇女为研究对象,随访置入后1、3个月的IUD避孕效果、不良反应和续用情况.多因素lo-gistic回归分析有宫颈松弛、宫颈宽大、既往IUD脱落史、分娩后或人工流产后即时放置IUD等特征的"特殊人群"使用不同类型IUD对随访结局的影响.结果:纳入使用固定式或支架式IUD者分别为1060人和1589人,固定式IUD组中特殊人群535例(占50.5％),支架式式IUD组中特殊人群288例(占18.1％).放置后3个月特殊人群中固定式IUD月经改变和白带异常的发生率较支架式IUD组低(16.8％比18.8％,3.0％比3.5％,均P＜0.05),续用率较支架式IUD组高(97.7％比92.8％,P＜0.001).多因素logistic回归分析显示,在一般人群中,放置后1个月固定式IUD发生月经改变的风险相较于放置支架式IUD低(OR=0.62,95％CI 0.45～0.85);放置后3个月固定式IUD组发生白带异常的风险均较低(一般人群OR=0.50,95％CI 0.29～0.80;特殊人群OR=0.43,95％CI 0.24～0.72);发生IUD脱落/异位的风险增加无统计学意义(一般人群OR=1.41,95％CI 0.52～3.53;特殊人群OR=1.57,95％CI 0.61～3.83).结论:固定式IUD在白带异常和月经改变方面的表现较优于传统的支架式IUD;在一般人群和特殊人群中,固定式IUD均为一种安全有效的避孕方式.

Abstract

Objective:To observe the safety,efficacy and continuation of the fixed intrauterine device(IUD)used in women of childbearing age.Methods:The women of childbearing age who had used the national free IUD from January to June 2022 in Guangxi were investigated.The women were followed up the contraceptive effect,adverse reactions and continuation of IUD inserted within 1 and 3 months.Multivariate logistic regression analysis was used to analyze the in-fluence of different types of IUD on the follow up outcomes of the"special population"with cervical laxity,cervical le-niency,previous IUD loss history,and IUD inserted immediately after delivery or abortion.Results:This study in-cluded 1060 fixed IUD users and 1589 stent IUD users.The"special population"included 535(50.5％)fixed IUD us-ers and 288(18.1％)stent IUD users.The incidences of the change of menstruation(16.8％)and the abnormal leukor-rhea(3.0％)of the fixed IUD users in the"special population"in 3 months after IUD inserted were significantly lower than those(18.8％and 3.5％)of the stent IUD users(P＜0.05).The rate of continuation of IUD used(97.7％)of the fixed IUD users in the"special population"was significantly higher than that(92.8％)of the stent IUD users(P＜0.001).Multivariate logistic regression analysis showed that in the general population,the risk of the change of menstruation of the fixed IUD users in 1 month after IUD inserted was significantly lower than that of the stent IUD users(OR=0.62,95％CI 0.45-0.85).In both the general and the special population,the risk of the abnormal leukor-rhea of the fixed IUD users in 3 months after IUD inserted was significantly lower than that of the stent IUD users(the general population:OR=0.50,95％CI 0.29-0.80;the special population:OR=0.43,95％CI 0.24-0.72).There were no statistically significant differences in the risk of IUD expulsion and dislocation between the fixed IUD users and the stent IUD users(the general population:OR=1.41,95％CI 0.52-3.53;special population:OR=1.57,95％CI 0.61-3.83).Conclusion:The fixed IUD outperforms the traditional stent IUD in terms of the vaginal bleeding and the abnor-mal leukorrhea.The fixed IUD is a safe and effective contraceptive in the general population and the special population.

关键词

宫内节育器/月经改变/白带异常/腰腹疼痛

Key words

Intrauterine device/Change of menstruation/Leukorrhea abnormal/Low back pain

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出版年

2024

中国计划生育学杂志

国家人口计生委科学技术研究所

中国计划生育学杂志

CSTPCD

影响因子：1.759

ISSN：1004-8189

参考文献量14

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