二次剖宫产术中放置吉娜固定式宫内节育器的效果和安全性研究*

目的:观察二次剖宫产术中放置吉娜固定式宫内节育器(GyneFixPP IUD)的疗效,并评价其安全性。方法:选择本院2011年1月至2013年2月既往曾行1次剖宫产的疤痕子宫孕妇共316例,其中上环组156例受术者均为自愿选择再次剖宫产术中放置吉娜环,对照组160例行常规再次剖宫产术,未上环或结扎。术后42d、3个月、6个月、12个月对两组患者进行随访,收集并分析两组术后出血、恶露及避孕环在位及不良反应等情况。结果:两组出血量、血性恶露持续时间及恶露持续时间差异均无统计学意义(P0.05)。产后3个月、6个月、12个月均出现经量增多、不规则出血、疼痛、白带增多及男方性交痛等副反应,但主诉不适逐渐减少,经相关处理后症状缓解或消失。上环组S-S距离为1.4-2.2 cm的在42d占77.50%,在3月占72.41%,在6月占82.14%,在12月占81.25%,其差异无统计学意义(P0.05)。上环组随访的151例产妇有4例(占2.65%)避孕环1年内自行脱出,因症取出2例(占1.32%),续用率为96.04%。上环组2年内意外妊娠0例,对照组5例,约占3.1%,5例均选择行人工流产结束妊娠。结论:二次剖宫产术中放置吉娜环安全,脱落率低,续用率高,避孕效果好,值得推广应用。

Effect and Safety of GyneFixPP IUD in the Second Cesarean Section*

ABSTRACT Objective: To observe the effect of GyneFixPP IUD in second cesarean section and evaluate its safety. Methods: A total of 316 pregnant women who had undergone 1 cesarean section in our hospital from January 2011 to February 2013 were selected, 156 patients were voluntarily chosen to GyneFixPP IUD in the second cesarean section as the Upper ring group,and 160 cases underwent routine cesarean section again as the control group, which were no upper ring and ligation. The two groups were followed up for 42d, 3, 6, and 12 months after operation, and the postoperative bleeding, lochia and contraceptive ring in two groups were collected and analyzed. Results: There was no significant difference in bleeding volume, bloody lochia duration and lochia duration between the two groups (P>0.05). There were side effects such as increased volume, irregular bleeding, pain, leucorrhea and male sexual intercourse pain at 3, 6, and 12 months after delivery, However, complaints were gradually reduced and symptoms relieved or disappeared after treatment. The S-S distance of 1.4-2.2 cm in the upper ring group was 77.50% in 42d, 72.41% in 3 months, 82.14% in 6 months and 81.25% in 12 months, and there was no significant difference between them (P>0.05). 4 cases (2.65%) of the contraceptive rings came out spontaneously within one year, 2 cases (1.32%) were removed because of symptoms in 151 cases of parturients followed up in the upper ring group, and the rate of continuation was 96.04%. There were 0 cases of accidental pregnancy in the upper ring group in 2 years, 5 cases in the control group, accounting for 3.1%, and 5 cases were terminated by artificial abortion. Conclusion: The GyneFixPP IUD is characterized by safety, low dropout rate, high rate of continued use and good contraceptive effect. It is worthy of popularization and application.