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目的研究宫内节育器(intrauterine device,IUD)放置术的术时情况对IUD异位的影响,从而提出针对性的预防措施。方法采用1:1匹配的病例对照研究,将2013年7月~2015年6月期间国家人口计生委计划生育药具不良反应监测中心收集的104例IUD异位患者作为研究组,将104例同期放置IUD后的健康妇女作为对照组。通过结构式调查表进行资料收集,运用条件logistic回归进行危险因素的分析。结果两组宫腔深度、子宫位置、术中出血、术中用药、术后给药以及术后告知注意事项的情况相比较,差异均无统计学意义(P>0.05)。两组术中疼痛发生率比较差异有统计学意义(P<0.05),术中疼痛是IUD异位的危险因素,OR值为5.00(95%CI:1.45~17.27),调整混杂因素后,OR值为21.54(95%CI:3.17~146.44)。结论术中疼痛显著增加IUD异位风险,故应加强此类人群的定期随访,以减少IUD异位的发生。
Objective To study the effect of intraoperative IUD placement on the ectopic position of IUD, and to propose targeted preventive measures. Methods A case-control study with 1: 1 matching was conducted. A total of 104 patients with IUD ectopic patients collected from the Adverse Reaction Monitoring Center for Family Planning Drugs of the National Population and Family Planning Commission between July 2013 and June 2015 were selected as study groups. 104 cases Healthy women after IUD placement served as control group. Through structured questionnaires for data collection, the use of conditional logistic regression analysis of risk factors. Results There were no significant differences in uterine cavity depth, uterine position, intraoperative bleeding, intraoperative medication, postoperative medication and postoperative cautions (P> 0.05). The incidence of intraoperative pain was significantly different between the two groups (P <0.05). Intraoperative pain was a risk factor for ectopic IUD with OR of 5.00 (95% CI: 1.45-17.27). After adjusting for confounding factors, OR The value was 21.54 (95% CI: 3.17-146.44). Conclusions Intraoperative pain significantly increases the risk of ectopic IUD, so regular follow-up of such population should be strengthened to reduce the incidence of ectopic IUD.