81例皮下埋植剂依托孕烯使用后临床分析  

Clinical Analysis of Subdermal Implant Etonogestrel in 81 Cases

作　　者：王玉楣 车映 WANG Yu-mei;CHE Ying(Department ofFamily Planning, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai200040, China)

机构地区：[1]同济大学附属第一妇婴保健院计划生育科

出　　处：《国际生殖健康／计划生育杂志》2019年第5期378-381,共4页Journal of International Reproductive Health/Family Planning

基　　金：上海市市级医疗卫生学科建设项目(2017ZZ02015)

摘　　要：目的:收集我院近2年使用皮下埋植剂依托孕烯的81例患者临床资料,分析影响皮下埋植剂使用的因素,为推广皮下埋植剂的使用提供临床依据。方法:回顾性收集2017年1月—2018年9月于我院计划生育科就诊,自愿选择要求放置或取出皮下埋植剂依托孕烯的81例患者临床资料,于2018年12月集中电话随访放置后是否出现与皮下埋植剂相关的不良反应以及后续处理和目前在用状态,探讨皮下埋植剂放置时机、放置原因、放置后出现的月经改变不良反应以及处理效果与目前是否在用的关系。结果:皮下埋植剂是高效的长效避孕措施;放置后发生闭经和不规则阴道出血情况的患者在皮下埋植剂放置时间上比较,差异无统计学意义(P>0.05);皮下埋植剂取出组与在用组在放置原因、出现月经改变不良反应是否治疗、放置后是否发胖方面比较,差异无统计学意义(P>0.05);2组在针对月经改变的用药治疗效果方面比较,在用组好于取出组,差异有统计学意义(P<0.05);皮下埋植剂用于避孕和同时用于缓解腺肌病痛经症状时,两者放置皮下埋植剂的时间长短比较,差异无统计学意义(P>0.05)。提前终止皮下埋植剂使用的人群后续避孕方法以避孕套为多。结论:皮下埋植剂避孕效果可靠;皮下埋植剂对改善腺肌病痛经症状有一定效果;皮下埋植剂对月经模式的改变随着放置时间的延长趋于固定化;影响皮下埋植剂取出的主要因素是患者对月经改变的治疗效果是否满意;后续针对出血模式改变的机制进行研究与治疗可能提高皮下埋植剂使用的满意度,提高皮下埋植剂作为长效安全避孕措施的使用效果。Objective:To evalute the clinical application of subdermal implant Etonogestrel, so as to provide more data for the expansion of this contraceptive method. Methods: The clinical data of 81 women who volunteered to implant or take out Etonogestrel was retrospectively analyzed in our Department from January 2017 to September 2018. The adverse reactions related to Etonogestrel were collected by the centralized -telephone follow -up visit in December 2018, including the implant timing, reasons for the implantation, menstruation disturbance and treatment, the use condition and others. Results: There was no significant difference in the time of amenorrhea and irregular vaginal bleeding after implantation of Etonogestrel (P>0.05);there were no significant differences in the causes of placement, the treatment of adverse reactions and the induced obesity between the removal group (the group A) and the using group (the group B)(all P>0.05). However, the therapeutic effect of adverse reactions in the group B was better than that in the group A (P<0.05). Interestingly, there was no significant difference in the removal rate between the two groups: the group of implantation for contraception and the group of implantation for the treatment of adenomyosis dysmenorrhea symptom (P>0.05). Condom was the most common method following the removal. Conclusions: Subdermal implant Etonogestrel is a reliable contraceptive, meanwhile there is treatment effect on ameliorating dysmenorrhea symptoms of adenomyosis. The change of menstrual pattern would be limited with the prolongation of placement time. The main factor affecting the removal of Etonogestrel is the therapeutic effect of menstrual changes. Therefore, the improvement in the therapeutic effect of menstrual changes will be helpful for the extented application of subdermal implant Etonogestrel as a long-term and safe contraceptive method.

关 键 词：皮下埋植剂 避孕药 药物植入物 依托孕烯 月经失调 

分 类 号：R169.41[医药卫生—公共卫生与预防医学]