摘要
目的探讨40岁及以上妊娠合并子宫肌瘤患者人工流产术后即时放置吉妮致美的有效性和安全性。方法选取2018年6月至2020年9月南京医科大学附属无锡妇幼保健院因非计划妊娠行人工流产术的90例妊娠合并子宫肌瘤患者作为研究对象。根据人工流产术后即时避孕方法分为曼月乐组(n=42)、吉妮致美组(n=48)。观察流产术后阴道出血时间、月经恢复时间及子宫恢复情况等,分析月经模式的改变及点滴出血情况,统计随访术后1个月、3个月和6个月的带器妊娠率、总终止率。结果曼月乐组与吉妮致美组术后阴道流血时间和月经恢复时间比较,差异无统计学意义(P>0.05)。吉妮致美组子宫内膜厚度显著大于曼月乐组,差异具有统计学意义(P<0.05)。吉妮致美组点滴出血、闭经的发生率与曼月乐组比较显著降低,但月经量增多的发生率显著升高,差异具有统计学意义(P<0.05)。两组术后1个月总终止率比较,差异无统计学意义(P>0.05);而吉妮致美组术后3个月、6个月脱落率、总终止率显著低于曼月乐组,差异具有统计学意义(P<0.05)。结论40岁及以上妊娠合并子宫肌瘤患者人工流产术后即刻放置吉妮致美、曼月乐均可实现良好的避孕效果,吉妮致美可有效降低点滴出血、闭经、脱落等副作用,提高续用率。
Objective To investigate the efficacy and safety of immediate placement of Genezyme after induced abortion in pregnant women over 40 years old with uterine fibroids.Methods 90 pregnant women with uterine fibroids who underwent induced abortion due to unplanned pregnancy in Wuxi Maternal and Child Health Hospital Affiliated to Nanjing Medical University from June 2018 to September 2020 were selected as the research subjects.According to the immediate contraceptive method after induced abortion,the patients were divided into Mirena group(n=42)and Genezyme group(n=48).The vaginal bleeding time,menstrual recovery time and uterine recovery after abortion were observed,and the changes of menstrual pattern and spotting were analyzed,the pregnancy rate with IUD and the total termination rate were followed up at 1,3 and 6 months after abortion.Results There was no significant difference in postoperative vaginal bleeding time and menstrual recovery time between Mirena group and Genizome group(P<0.05),and endometrial thickness in Genizome group was significantly greater than Mirena group(P<0.05).Compared with Mirena group,the incidence of spotting and amenorrhea in Genizome group was significantly decreased,but the incidence of menstrual volume was increased significantly(P<0.05).There was no significant difference in the total termination rate at 1 month after induced abortion between the two groups(P<0.05),but the expulsion rate and total termination rate at 3 and 6 months after induced abortion in Genizome group was significantly lower than that in Mirena group(P<0.05).Conclusions Immediate placement of Genezyme or Mirena after induced abortion in pregnant women with uterine fibroids over 40 years old both can achieve good contraceptive effect,while Genezyme can effectively reduce side effects such as spotting,amenorrhea and expulsion,and improve the continued rate.
作者
尹婷婷
沈晔
钱芳波
YIN Tingting;SHEN Ye;QIAN Fangbo(Department of Family Planning,Wuxi Maternal and Child Health Hospital,Nanjing Medical University,Wuxi 214002,Jiangsu,China)
出处
《中国性科学》
2021年第9期62-65,共4页
Chinese Journal of Human Sexuality
基金
江苏省妇幼健康重点学科资助项目(FXK2017)
中华医学会青年长效可逆避孕(青年LARC)专项研究基金(GJB-3-20190805-335)
江苏省无锡市卫生健康委科研项目(M202057)。
关键词
妊娠
子宫肌瘤
人工流产术
避孕效果
吉妮致美
曼月乐
Pregnancy
Uterine fibroids
Induced abortion
Contraceptive effect
Genezyme
Mirena
