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目的探讨瘢痕子宫患者人工流产术后宫内节育器置入的应用效果及预后分析。方法选择人工流产术后置入节育器的450例妇女根据有无剖宫产史以及剖宫产术后时间将其分为3个组,其中剖宫产术后12个月内置入节育器的150例妇女为A组,剖宫产术后>12个月置入节育器的150例妇女为B组,150例无剖宫产史妇女为C组,比较3组妇女应用效果以及不良反应发生率。结果 3组妇女带器妊娠和部分脱落发生率在12个月内均为0,3组妇女累计续用率随着置入时间延长而降低,而3组比较差异无统计学意义(P>0.05)。1个月内,B组妇女完全脱落为1.33%,其余全为0。置器3个月后,A、C组妇女因出血取出分别为2.04%、0.68%,3组妇女3个月因出血取出差异无统计学意义(P>0.05)。6个月时3组妇女因出血取出分别为2.04%、2.70%、2.05%,因疼痛取出分别为0.00%、1.35%、1.37%,3组妇女6个月因出血取出差异无统计学意义(P>0.05)。12个月时3组妇女因出血取出分别为2.05%、1.35%、2.11%,差异无统计学意义(P>0.05)。置入宫内节育器后第1个月A组经期延长或者缩短(16.00%)、经量增加发生率(10.00%)均高于B组(14.00%、8.00%)和C组(14.67%、8.67%),但3组差异无统计学意义(P>0.05)。在置器3、6、12个月后,3组妇女经期延长或者缩短、经量增加、不规则出血、腰腹痛以及白带增多发生率比较差异无统计学意义(P>0.05),而不规则出血、腰腹痛以及白带增多发生率随着时间延长而逐渐降低。结论瘢痕子宫妇女在1年内进行人工流产术后宫内节育器置入取得显著的避孕效果,并且安全可靠,值得推广使用。
Objective To investigate the effect and prognosis of intrauterine devices after artificial abortion in patients with uterine scar. Methods 450 women with IUD insertion after artificial abortion were divided into 3 groups according to the history of cesarean section and the time after cesarean section. Among them, 12 women who underwent cesarean section were placed in the IUD 150 women were in group A, 150 women in group I was> 12 months after cesarean section were in group B. 150 women without history of cesarean section were in group C. The effects of the three groups of women and the adverse reactions were compared rate. Results The incidence of pregnancy and partial shedding in the three groups were all 0 and 3 in 12 months. The cumulative renewal rate of women decreased with the prolongation of insertion time, but there was no significant difference between the three groups (P> 0.05 ). Within 1 month, women in group B completely lost 1.33% and all others were 0. Three months after the device was set, the women in group A and group C took 2.04% and 0.68% respectively due to the bleeding, and the difference was not statistically significant (P> 0.05). At 6 months, the bleeding in 3 groups of women was 2.04%, 2.70% and 2.05%, respectively. The pain relief was 0.00%, 1.35% and 1.37%, respectively. There was no significant difference in the three groups of women taking bleeding after 6 months P> 0.05). At 12 months, the bleeding in 3 groups of patients was 2.05%, 1.35% and 2.11%, respectively, with no significant difference (P> 0.05). In the first month after IUD insertion, the duration of menstruation in group A was prolonged or shortened (16.00%), and the incidence of volume increase (10.00%) was higher than that in group B (14.00%, 8.00%) and group C (14.67% 8.67%), but there was no significant difference among the three groups (P> 0.05). There was no significant difference in the incidence of irregular menstruation between the three groups at 3, 6 and 12 months after menstruation (P> 0.05). However, there was no significant difference in the incidence of irregular menstruation, irregular bleeding, abdominal pain and leucorrhea Bleeding, abdominal pain and increased incidence of leucorrhea gradually decreased over time. Conclusion Women with scar uterus achieved significant contraceptive effect after intrauterine device implantation within 1 year and are safe and reliable. It is worth popularizing.