宫内节育器异位影响因素的分析  

Analysis of Risk Factors of Ectopic IUD

作　　者：张敏[1] 周健[1] 李瑛[1] 

机构地区：[1]国家人口计生委计划生育药具不良反应监测中心,江苏省计划生育科学技术研究所,南京210036

出　　处：《国际生殖健康／计划生育杂志》2012年第4期284-287,共4页Journal of International Reproductive Health/Family Planning

基　　金：中央财政专项"避孕药具不良反应监测与防治";"十一五"国家科技支撑计划课题"避孕药具上市后监测和风险再评价研究"(2006BAI15B07);江苏省科技厅项目"江苏避孕药具上市后监测与风险评价业务建设"(BM2009904)

摘　　要：目的:了解宫内节育器(intrauterine device,IUD)异位的影响因素,降低IUD严重伤害事件的发生风险,为指导IUD的临床安全使用提供参考依据。方法:对国家人口计生委计划生育药具不良反应监测中心数据库中的IUD异位的前6种类型的IUD异位的不良事件进行分析,了解发生IUD异位事件的人群特征,并分析可能与IUD异位相关的风险因素。结果:数据库中记录发生异位的IUD前6种类型为:爱母功能型、TCu220C、活性165、元宫220、金属单环、宫铜200;236例IUD异位类型为:部分异位210例,占88.98%,完全异位有6例,占2.54%,子宫外异位20例,占8.48%;疼痛在所有临床症状中所占比例最高(38.98%);随着放置时间增加,闭合型IUD发生异位的风险逐渐增加(趋势性检验P<0.000 1)。结论:IUD异位可能与其种类、放置时间有关,疼痛可能是发现异位的主要线索,日常工作中要特别注意定期随访。Objective： To evaluate the risk factors of ectopic intrauterine device （IUD）, so as to prevent the adverse events of ectopic IUD,and to conduct the safest use of IUDs. Methods： By analyzing the top six adverse events of IUDs which submitted to the database of National Population and Family Planning Commission （NPFPC） contraceptive adverse reaction monitoring center, we explored the incidences of IUDs adverse events, patient＇s characteristics such as age, parity and breasffeeding status, to analyze the risk factors of ectopic IUDs. Results： The top six IUDs were MCu IUD,TCu220C,medicated stainless steel ring-165 （containing copper）, YuanGong IUD,stainless steel ring,copper uterine cavity-shaped intrauterine devices （UCD200）. Totally,there were 236 ectopic IUDs. 210 IUDs （88.98%） were partial embedded into the endometrial and muscular layer,6 IUDs （2.54%） were complete into the endometrial and muscular layer,20 IUDs （38.98%） were migrated outside the uterus. Abdominal pain was the main events detected in the clinical symptoms. The close-model IUDs got higher risk of translocation following the transfer time of IUDs （P〈0.000 1 ）. Conclusions： IUDs type and the time after transfer might be associated with the ectopic IUDs. Abdominal pain was trigger for detection of ectopic IUDs. Women with IUDs should have regular follow-up visits.

关 键 词：宫内避孕器 危险因素 疼痛 

分 类 号：R169.4[医药卫生—公共卫生与预防医学]