吉妮致美IUD对月经出血模式影响及特殊时期使用的系统评价  

A systematic review of effects of medicated GyneFix intrauterine device on menstrual bleeding pattern and use in special circumstances

作　　者：张文[1,2] 王琨 吴尚纯 

机构地区：[1]北京协和医学院研究生院,100081 [2]国家卫生计生委科学技术研究所 [3]青岛市妇女儿童医院

出　　处：《中国计划生育学杂志》2014年第12期796-802,816,共8页Chinese Journal of Family Planning

摘　　要：目的：系统评价吉妮致美与其他吉妮系列产品对月经出血模式的影响,以及吉妮致美在特殊情况下使用的效果.方法：计算机检索CNKI（1979～ 2014）、CBMdisc（1978～ 2014）、万方（1982～ 2014）、维普（1989～ 2014）数据库,并结合手工检索相关杂志.根据纳入、排除标准筛选文献,并经质量评价后,采用RevMan 5.0软件进行meta分析.结果：文献检索共检到580篇文献,根据纳入排除标准,最终纳入7篇已发表研究.分析结果显示：①在经量增多发生率、经期延长发生率、点滴出血发生率方面,吉妮致美普遍低于吉妮IN和吉妮柔适;②在人工流产后即时放置吉妮致美和宫铜200宫内节育器（IUD）的比较中,吉妮致美具有更低的脱落相关终止率和因症取出率;③在有剖宫产史的妇女中,带器妊娠率、脱落相关终止率、因症取出率方面,吉妮致美均低于元宫Cu220 IUD或TCu220C IUD,在脱落相关终止率、因症取出率方面,吉妮致美均低于TCu380A IUD.结论：吉妮致美可以有效改善月经出血模式,同时在人工流产后即时放置或者有剖宫产史的妇女中放置时,可以有效预防妊娠、降低IUD脱落率并减少因症取出率,进而提高续用率,值得推广应用.Objective： To evaluate menstrual bleeding patterns after insertion of medicated GyneFix intrauterine device （IUD） when compared with other products of GyneFix series and the contraceptive efficacy when used in special circumstances. Methods： We searched medical databases including CNKI （1979--2014）, CBMdisc （1978--2014）, Wan- fang Database （1982--2014）, VIP Database （1989--2014） by computer. And we screened the articles and then per- formed a recta--analysis by using RevManS.0 software. Results： Seven articles from 580 literature were recruited for recta--analysis according to inclusion and exclusion criteria. The analysis results showed that incidences of menorrha- gia, prolonged menstrual bleeding, spotting bleeding of medicated GyneFix IUD were generally lower than those of GyneFix IN and GyneFix soft threads IUDs. The expulsion rate and the removal rate for medical reason of medicated GyneFix IUD immediately inserted after abortion were lower than those of Gong copper 200 IUD. Among women with cesarean history, the pregnancy rate with IUD in situ, the expulsion rate and the removal rate for medical reason of medicated GyneFix IUD were lower than those of Yuangong copper 220 or copper T 220C IUDs, while the expulsion rate and the removal rate for medical reason of medicated GyneFix IUD were lower than those of copper T 380A IUD. Conclusion： Medicated GyneFix can improve the menstrual bleeding pattern, also it can prevent the pregnancyeffectively, reduce the expulsion rate and the removal rate for medical reason even when used in special circumstances. So it has the favorable contraceptive efficacy and is worth using widely.

关 键 词：文献分析 吉妮 终止率 月经出血模式 宫内节育器 

分 类 号：R169.4[医药卫生—公共卫生与预防医学]