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目的观察常用的3种宫内节育器(IUD)的临床应用效果。方法2004年11月至2007年11月本院与铁岭市妇婴医院2家医院采用对比性研究,以随机方法将1673例健康育龄妇女放置3种不同IUD,其中活性元宫IUD525例,MCuIUD662例,TCu220IUD486例,于放置后1、3、6、12、24个月进行随访。结果3种IUD24个月的妊娠率、脱落率、因症取出率和累积续用率分别为:活性元宫IUD0.56%,0.59%,2.41%,96.05%;MCuIUD0.34%,0.15%,2.03%,97.17%;TCu220IUD0.42%,5.17%,3.79%,90.01%。经统计学处理,3种IUD妊娠率比较,差异无显著性意义(P>0.05);活性元宫IUD和MCuIUD的脱落率低于TCu220IUD,差异有非常显著性意义(P<0.01);活性元宫IUD和MCuIUD的因症取出率低于TCu220IUD,差异有统计学意义(P<0.05);活性元宫IUD和MCuIUD的24个月的累积续用率高于TCu220IUD,差异有非常显著性意义(P<0.01)。结论活性元宫IUD和MCuIUD具有脱落率低,因症取出率低,累积续用率高的优点,值得推广。
Objective To observe the clinical effect of three kinds of intrauterine devices (IUDs) commonly used. Methods From November 2004 to November 2007, two hospitals of our hospital and Tieling Maternity and Child Hospital were compared. Randomly, 1673 healthy women of childbearing age were placed in three different IUDs, of which IUD525 and MCuIUD662 , TCu220IUD486 cases were placed at 1,3,6,12,24 months after follow-up. Results The pregnancy rate, exfoliation rate, withdrawal rate and accumulative success rate of three IUDs at 24 months were as follows: active IUD 0.56%, 0.59%, 2.41%, 96.05%; MCuIUD 0.34%, 0.15% 2.03%, 97.17%; TCu220IUD 0.42%, 5.17%, 3.79%, 90.01%. There was no significant difference between the three IUD pregnancy rates (P> 0.05). The IUD and MCuIUD shedding rate in the active IUP is lower than that of the TCu220IUD, the difference was statistically significant (P <0.01) The removal rates of IUD and MCuIUD were lower than that of TCu220IUD (P <0.05), and the cumulative follow-up rates of IUD and MCuIUD at 24 months were higher than that of TCu220IUD P <0.01). Conclusion The active IUD and MCuIUD have the advantages of low rate of exfoliation, low rate of exacerbation and high cumulative follow-up rate, which deserves promotion.