剖宮產史對女性人工流產術后即時放置宮內節育器的影響探究

楊東艷 田穎

【摘要】目的：探討剖宮產史對女性人工流產術后即時放置宮內節育器的影響。方法：選擇390例于2013年7月至2014年11月收治于我院的剖宮產術后行人工流產術后即時放置IUD的婦女，分為三組，其中123例剖宮產術后12個月內的患者稱為觀察組Ⅰ，92例剖宮產術后12個月以上的患者稱為觀察組Ⅱ，175例無剖宮產史患者稱為對照組Ⅲ。三組患者行人工流產術后即時放置IUD并進行隨訪觀察12個月，對比三組患者治療后有無發生副作用及避孕效果。結果：三組患者在置入IUD后1、3、6、12個月后發生經期延長、經量增加、閉經、 不規則出血、腰腹痛、白帶增多等副作用情況均無顯著差異（均P>0.05），且均無出現閉經（宮腔粘連）情況；三組患者中，術后6個月隨訪時的因出血、因疼痛取出率為最高，但差異無統計學意義（P=0.452，P=0.538），三組患者術后12個月隨訪時并未發現有帶器妊娠；除術后1個月隨訪時觀察組Ⅱ有1例出現完全脫落外，其余隨訪時間段各組均無出現脫落情況；三組患者在術后1、3、6、12個月隨訪中的累計續用率差異不大，無統計學意義（均P>0.05）。結論：剖宮產手術史對再次妊娠的女性行人工流產術后即時放置IUD的效果和安全性無明顯影響，有剖宮產史的妊娠女性可采用人工流產術后放置IUD的方式避免重復妊娠。

【關鍵詞】瘢痕子宮；宮內節育器；副作用；人工流產；宮內避孕

Clinical observation and side effect of IUD insertion immediately after induced abortion among women with cesarean sectionYANG Dongyan1，2 ， TIAN Ying1. 1. Department of Gynecology， Shaanxi Province Traditional Chinese Medicine Hospital，Xian 710003，Shaanxi，China； 2. Tianjin University of Traditional Chinese Medicine， Tianjin 300143， China

【Abstract】Objectives： To explore the clinical observation and side effect on IUD insertion immediately after induced abortion among women with cesarean section. Methods： 390 women with cesarean section inserted with IUD immediately after induced abortion in our hospital from July 2013 to November 2014 were selected and divided into 3 groups， 123 patients within 12 months after cesarean section as observation groupⅠ， 92 patients over 12 months after cesarean section as observation group Ⅱ， and 175 cases without cesarean section were referred to as the control group Ⅲ. The three groups underwent artificial abortion immediately after placement of IUD and were followed up for 12 months. Incidence of side effects and contraceptive effect of the three groups was compared. Results： The three groups had no significant difference in menstrual extension， menstrual amount， amenorrhea， irregular bleeding， lumbar pain and leucorrhoea and other side effects 1， 3， 6 and 12 months after IUD insertion （all P>0.05）， and there were no amenorrhea （IUA）. In the 3 groups， the rate of removing IUD due to bleeding and pain was the highest at 6 months follow-up， without statistically significant difference （P=0.452， P=0.538）. There was no pregnancy in the 12-month follow-up in the three groups； there was only a case of shedding in observation group Ⅱat 1-month follow-up； Difference in the cumulative rate of continued use was not statistically significant 1， 3， 6 and 12 months after IUD insertion （all P>0.05）. Conclusions： IUD insertion immediately after induced abortion can effectively avoids the risk of recurrent miscarriage， with high security and feasibility.

【Key words】Scar uterus； Intrauterine device （IUD）； Side effect； Induced abortion； Intrauterine contraception

【中圖分類號】R169.41；R714；R719.3+4【文獻標志碼】A

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