左炔诺孕酮宫内缓释系统取出原因分析  

Analysis of causes of removal of levonorgestrel-releasing intrauterine system

作　　者：冯旺琴[1] 李军[1] 陈素文[1] 

机构地区：[1]首都医科大学附属北京妇产医院计划生育科,北京100026

出　　处：《生殖医学杂志》2016年第3期237-241,共5页Journal of Reproductive Medicine

摘　　要：目的分析左炔诺孕酮宫内缓释系统（LNG-IUS）取出原因及影响因素,提高继续使用率。方法对2014年3月至2015年3月来本院自愿要求取出曼月乐的111例门诊患者的临床资料进行回顾性分析,探索取出的原因和放置曼月乐可能出现的并发症。结果 （1）111例患者年龄22～54岁,109例一次取器成功,2例因为节育器异位在剖宫产切口憩室处,门诊取器失败,收入院行宫腔镜下宫内节育器取出。（2）26例（23.42%）为到期取出,其中13例取出后再次放置曼月乐,5例取出后改放置其他宫内节育器;62例因症取器,占55.86%,其中34例（30.63%）是由于闭经问题;20例（18.02%）因计划妊娠取出;3例（2.70%）因异位或下移取出。（3）无带器妊娠病例。结论 LNG-IUS因症取器比例较高,患者主要不能忍受闭经带来的焦虑;应做好宫内节育器放置前患者的咨询,并加强放置后随访,积极防治置器后的副反应和并发症。Objective： To analyze the reasons and influencing factors of removing levonorgestrel releasing intrauterine system （LNG-IUS;Mirena）,in order to improve LNG-IUS utilization. Methods： The clinical data of 111 patients visited our hospital for voluntarily removing Mirena were retrospectively analyzed for exploring the removal causes and possible complications of Mirena insertion. Results. The age range of 111 patients was 22-54 years. IUDs were successfully removed in 109 patients. The IUD removal was failed in two patients due to ectopic IUD in diverticulum of caesarean incision,and the IUD was removed under hysteroscope subsequently. The IUD was removed at maturity in 26 patients （23.42%）. Among 26 patients,Mirena was inserted again in 13 patients, while Mirena was replaced by other type of IUD in 5 patients. Sixty two patients＇ IUDs were removed due to complications of the IUD insertion （55.86%）. Among them,34 patients （30.63%） were due to amenorrhea problem,20 patients （18. 02%） for intending pregnancy,3 patients （2. 70%） for ectopie or shift down. No pregnancy with intrauterine device in situ was happened.Conclusions： the patients cannot before insertion of insertion of IUD. The proportion of IUD removal due to complications is higher. The main reason is that tolerate the anxiety caused by amenorrhea. It is necessary to give counseling to patients Mirena, and strengthen follow-up and treat the side effects and complications after insertion of IUD.

关 键 词：左炔诺孕酮宫内缓释系统 宫内节育器 取出原因 计划生育 

分 类 号：R714.22[医药卫生—妇产科学]