输卵管注药绝育术副反应和并发症的近远期观察  

Observations of the Short and the Side Effects and Complications Long Term after the Procedure of Fe-male Tubal Sterilization by Chemical Instillation

作　　者：刘云嵘 吴裕浩[2] 陈学煌[3] 黄真嘉 徐铎 蔡光宗 

机构地区：[1]国家计划生育委员会科研所,北京100081 [2]上海第二医科大学附属新华医院 [3]中山医科大学附属孙逸仙纪念医院 [4]山东省计划生育科研所 [5]河北省计划生育科研所 [6]陕西省妇幼保健院

出　　处：《中国计划生育学杂志》1998年第7期304-308,共5页Chinese Journal of Family Planning

摘　　要：采用多中心随机化临床试验,共接纳1705例合格受术对象,其中871例使用复方苯酚糊剂(PAP),834例使用显影苯酚胶浆(PM)。观察结果表明,术后发热率两组分别为8.0％和4.4％,组间差别有统计学意义。发热主要因药物反应所致。两组附件感染率分别为2.3‰和1.2‰。盆腔化学性腹膜炎发生率分别为1.1‰和2.4‰。未见子宫穿孔、盆腔脓肿和宫外孕。术后伴有轻度腹痛者分别占33.6％和30.8％,偶见重度者。腹痛与药物在卵管内充盈的长度和引起的组织反应范围明显有关。腰痛情况与腹痛相似。术后有症状者,多数在短时间内缓解,少数需对症治疗。术后,轻度子宫出血者两组分别为23.2％和18.0％。出血与术时取出节育器明显有关。本术对受术妇女月经无明显影响。五年随访做妇科检查和宫颈细胞学检查无阳性发现,也未查见与绝育药物主要成份有关的潜在疾患。研究表明,本术安全可靠。为进一步降低副反应和并发症的发生,研究机构应着重于现有药物配方的改进,并在保证效果的基础上,尽量减少阿的平含量。主管部门应重新估价这一技术,并加强施术管理和施术者培训,制定全国统一的操作规范,确保服务质量。本术现已得到广泛使用,有很大的发展前景,各界应予更大的关注。Objectives: The present objective is to observe the side effects and complication of female tubal sterilization by PAP and PM. Methods: 1705 eligible women were divided randomly into two groups, 871 using PAP and 834 women using PM. Results: the fever rates were 8.0% and 4. 4% ( P < 0. 01) respectively in group PAP and group PM. The infection rates of appendages were 2.3‰ and 1.2‰ respectively. The incidence rates of chemical peritonitis, within the limits of pelvic cavity, were 1.1‰ and 2.4‰ respecticety.The perforation of uterus, pelvic obscess and ecttopic pregnancy were not found during this observations. The percentages of slight abdominal pain after the procedures were 33.6 % and 30.8 % respectively. The percentage of a slight endomentrorrhagia after the procedure was 23.2 %and 18. 0% respectively. The menstruation of women was not affected by the instillation. This five - year follow - up results neither show a positive Pap test nor find a potential desease causing by the agents. Conclusion: this technique is a safe and efficient method for women sterilization.

关 键 词：输卵管注药 绝育术 复方苯酚糊剂 并发症 

分 类 号：R169.41[医药卫生—公共卫生与预防医学]