二次剖宫产术中放置吉妮柔适固定式宫内节育器的临床研究  

Clinical research of secondary cesarean section of placing jeannie soft comfortable type intrauterine device

作　　者：徐雪花 吕绍勋 刘倩晨 王静 陈雨 陈如 

机构地区：[1]河南省项城市计划生育服务站,466200 [2]项城市中医院

出　　处：《中国实用医刊》2017年第11期59-62,共4页Chinese Journal of Practical Medicine

摘　　要：目的 探讨二次剖宫产术中放置固定式宫内节育器的可行性,落实二次剖宫产术后长效避孕节育措施,降低剖宫术后1年内的意外妊娠率,减少因此而造成的身心伤害.方法 随机选择2014年1月至2015年8月在项城市计划生育服务站、项城市中医院住院分娩的足月妊娠、计划行剖宫产产妇,按照随机双盲法分为研究组（A组）：首次剖宫产200例（A1组）,二次及以上剖宫产220例（A2组）;对照组（B组）：同期剖宫产（含首次、再次）共计310例;A组产妇在剖宫产术中即时给予放置固定式宫内节育器（IN/S型）吉妮柔适IUD;B组产妇不放置宫内节育器,哺乳期使用避孕套避孕.观察分析两组术后24 h出血量,血性恶露持续时间,产后6个月子宫恢复情况.随访比较,A、B两组间1年内带器妊娠率、脱环率、因症取环率、继续使用率,和意外妊娠率等发生情况.结果 A1、A2组与B组比较,24 h阴道出血量[（258.45±68.72）ml,（267.37±59.14）ml,（254.17±60.24）ml）]、血性恶露持续时间[（5.26±1.16）d,（4.83±2.22）d,（5.16±1.98）d）]、子宫复旧率（99.5%、99.1%、99.7%）比较差异未见统计学意义（F=2.47、2.42,x2=0.73,P〉0.05）.A1、A2组带器妊娠率（0.25%,0.34%）、脱环率（0.38%,0.23%）、因症取环率（0.38%,0.23%）、继续使用率（97.6%,96.3%）、经期延长率（7.5%,6.8%）、不规则出血率（5.6%,3.2%）和腹痛发生率（1.0%,1.35%）比较差异未见统计学意义（x2=0.12、0.31、0.31、2.64、0.03、3.33、0.23,P〉0.05）.A、B两组间意外妊娠率分别为1.11%和12.26%,差异有统计学意义（x2=116.62,P〈0.001）.结论 二次剖宫产术中放置固定式宫内节育器是一项安全的避孕节育方法,不增加产后出血量及恶露持续时间,不影响子宫复旧,能显著降低二次剖宫产术后哺乳期的意外妊娠率,为二次剖宫产术后即时避孕提供了良好的避孕方法.Objective To investigate the feasibility of placing fixed intrauterine device in secondary cesarean section, carrying out the secondary long-term contraception measures after cesarean section, reducing the postoperative cutting palace accidental pregnancy rate within a year, and reducing physical and mental damage.Methods This paper randomly selected childbirth full-term pregnancy from January 2014 to August 2014 in the family planning service station of Xiangcheng city and traditional Chinese medicine hospital of Xiangcheng city.Line plan cesarean delivery mothers, according to the randomized double blind method was divided into research group （group A）： the first cesarean section of 200 cases （group A1）, two or more cesarean section 220 cases （group A2）;Control group （group B）： in the same period cesarean delivery （including for the first time again） a total of 310 cases;group A place fixed on cesarean section intraoperatie instant give maternal intrauterine device （IN/S） Jeannie soft comfortable IUD;group B not placed intrauterine device, maternal lactation condom use birth control.The blood loss, postoperative 24 hours hemorrhagic duration of lochia, and 6 months postpartum uterine recovery was analyzed.According to the follow-up comparison, the pregnancy rate within 1 year, took off the ring rate, due to the disease rate, continue to use rate, and accidental pregnancy rate was compared.Results There was no significant difference in 24 hours vaginal haemorrhage amount [（258.45±68.72）ml, （267.37±59.14 ml）, （254.17±60.24 ml）], hemorrhagic lochia duration [（5.26±1.16） days and （5.26±2.22） days, （5.16±1.98） days], uterine instauration rate （99.5%, 99.1%, 99.7%） among the three groups （F value were 2.47, 2.47, x2=0.73, P〉0.05）.There was no significant difference in pregnancy rate （0.25%, 0.34%）, take off the ring rate （0.38%, 0.38%）, due to the disease for ring rate （0.38%, 0.38%）, continue to use （97.6%, 97.6%）, menstrual extensio

关 键 词：二次剖宫产 避孕节育方法 吉妮柔适IUD 安全性 

分 类 号：R719.8[医药卫生—妇产科学]