三维经阴道超声评估宫内节育器位置异常及不良反应的临床研究  

Clinical study of three-dimensional transvaginal ultrasound in assessing abnormal position and adverse reactions of intrauterine device

作　　者：陈艳杰 任敏 姜中慧 李克婷 刘宇杰[1] 车国英[1] 杨宏宇 谢艳秋 吴新宇 田家玮[1] Chen Yanjie;Ren Min;Jiang Zhonghui;Li Keting;Liu Yujie;Che Guoying;Yang Hongyu;Xie Yanqiu;Wu Xinyu;Tian Jiawei(Department of Ultrasound, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China;Department of Ultrasound, the First Maternal and Child Health Hospital Affiliated of Tongji University, Shanghai 200000, China)

机构地区：[1]哈尔滨医科大学附属第二医院超声医学科,哈尔滨150086 [2]同济大学附属第一妇婴保健院超声科,上海200000

出　　处：《中华超声影像学杂志》2019年第5期439-443,共5页Chinese Journal of Ultrasonography

摘　　要：目的探讨三维经阴道超声评估宫内节育器(IUD)位置异常及不良反应的发生情况,指导IUD的正确选择。方法选择2016年7月至2018年2月来我院健康体检的女性志愿者作为研究对象,获取其带环时间、带环次数等信息,通过三维经阴道超声观察并记录IUD类型、位置情况等,回顾性分析不同种类型IUD位置异常、不良反应及宫颈病变的发生情况。结果 2 113例符合标准的受试者纳入研究,其中爱母环423例,圆形环506例,宫型环405例,T型环372例,γ环407例。带环后不良反应的发生率高达34.07%,不同IUD不良反应发生率不同,爱母环不良反应发生率最高,与圆形环、宫型环、T型环、γ环比较差异有统计学意义(47.99%对25.88%,27.41%,37.10%,33.66%;均P<0.05)。同一不良反应发生的IUD类型亦不同,爱母环和γ环腰痛率高于其余三种IUD,爱母环与圆形环、宫型环、T型环比较差异有统计学意义(23.4%对15.71%,14.07%,13.71%;均P<0.01)。不同类型IUD位置异常的发生率不同,圆形环下移率最高,与爱母环、γ环比较差异有统计学意义(6.32%对3.30%,3.19%;均P<0.05),与宫型环、T型环下移率差异无统计学意义(6.32%对3.45%,4.30%;均P>0.05);爱母环嵌顿率最高,与圆形环、宫型环、T型环比较差异有统计学意义(3.07%对0,0.25%,0.54%;均P<0.01)。宫型环与γ环宫内旋转率较高,与爱母环、圆形环、T型环比较差异有统计学意义(均P<0.01)。孕次>1次和带环次数≥2次均与IUD不良反应的发生有关(P<0.05)。T型环宫颈糜烂发生率最高,与爱母环、圆形环、宫型环、γ环比较差异有统计学意义(30.65%对16.78%,16.80%,18.02%,17.69%;均P<0.01)。结论女性置环后不良反应的发生率较高,不同类型IUD的不良反应和不良反应发生率均不同;不同类型IUD位置异常的发生率不同;孕次和带环次数与IUD不良反应的发生有关。Objective To investigate the incidence of abnormalities and adverse reactions of intrauterine device (IUD) by three-dimensional transvaginal ultrasound, and guide the correct selection of IUD. Methods Female volunteers who came to our hospital for health check-up from July 2016 to February 2018 were selected as subjects to obtain information of the belt loop time and number of loops. Three-dimensional transvaginal ultrasound was used to observe and record the IUD types and positions. The incidence of location abnormalities, adverse reactions and cervical lesions of differnet types of IUD were retrospectively analyzed. Results Two thousand one hundred and thirteen eligible subjects were included in the study, including 423 cases of McuIUD, 506 cases of circular ring, 405 cases of uterine ring, 372 cases of T-ring and 407 cases of γ ring. The statistical analysis showed that the incidence of adverse reactions after wearing rings was as high as 34.07%, and the adverse reaction rate of different IUD was different. McuIUD had the highest incidence of adverse reactions, compared with the circular ring, the uterine ring, the T-ring, and the γ ring (47.99% vs 25.88%, 27.41%, 37.10%, 33.66%;all P<0.05). Different IUD had different incidence of adverse reactions. The low back pain rate in McuIUD and γ ring were higher than the other 3 IUDs. The low back pain rate of McuIUD was higher than the circular ring, the uterine ring and the T-ring (23.4% vs 15.71%, 14.07%, 13.71%;all P<0.01). Different types of IUD had different incidence of location anomalies. The descending rate of the circular ring was higher than that of the McuIUD and γ ring (6.32% vs 3.30%, 3.19%;all P<0.05), and no statistically significant difference compared with the uterine ring and T-ring (6.32% vs 3.45%, 4.30%;all P>0.05). The incarceration rate of the mother ring was higher than that of the circular ring, uterine ring and T-ring (3.07% vs 0, 0.25%, 0.54%;all P<0.01). The intrauterine rotation rate of uterine ring and γ ring were higher than that o

关 键 词：超声检查 经阴道 三维 宫内节育器 不良反应 位置异常 

分 类 号：R445.1[医药卫生—影像医学与核医学] R169.41[医药卫生—诊断学]