不同临床应用时左炔诺孕酮宫内缓释系统取出原因分析
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南京医科大学“十二五”教育研究课题(JYY2015034)


Removal reasons of levonorgestrel ⁃ releasing intrauterine system for different clinical applications
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    摘要:

    目的:分析左炔诺孕酮宫内缓释系统(levonorgestrel-releasing intrauterine system,LNG-IUS)的取出原因及使用满意度,探讨如何提高续用率,加强对使用LNG-IUS患者的管理。方法:对2015年1月—2018年6月南京医科大学第一附属医院自愿取出LNG-IUS的407例患者的资料进行回顾性分析,按初始放置LNG-IUS的原因分为避孕组及治疗组,对比两组妇女取出LNG-IUS的原因及上环期间的满意度。结果:上环期间两组均无妊娠发生。两组首要取器原因均为因症取器,闭经及阴道点滴出血为主要原因。而治疗组的续用率及满意率均显著高于避孕组(P < 0.05)。与治疗组相比,避孕组有更多比率的妇女因激素相关不良反应而取器(P < 0.05),主要为面部痤疮和色素沉着(P < 0.05)。在因闭经取器妇女中,治疗组的置环时间及满意率显著大于避孕组(P < 0.05)。结论:针对不同临床应用LNG-IUS人群,需给予不同的指导策略,包括上环前详细告知各种不良作用、上环后做好随访并及时处理各种不良反应及并发症,以期减少取器率,提高满意率。

    Abstract:

    Objective:This study aims to analyze the reasons for the removal of levonorgestrel-releasing intrauterine system(LNG-IUS)and the satisfaction of patients,and to explore how to improve the continuous use rate and strengthen the management of patients with LNG-IUS. Methods:The data of 407 patients who voluntarily removed LNG-IUS from January 2015 to June 2018 in our hospital were retrospectively analyzed. According to the reasons for initial LNG-IUS placement in different clinical application,the patients were divided into the contraceptive group and the treatment group. Reasons for removing the LNG-IUS and the satisfaction of patients were compared between both groups. Results:No pregnancy occurred in both groups. The primary reasons for the removal of LNG-IUS in both groups were symptomatic,including amenorrhea and vaginal drip bleeding,and the continued use rate and satisfaction rate of the treatment group were significantly higher than those of the contraceptive group(P < 0.05). Compared with the treatment group,more women in the contraceptive group removed LNG-IUS due to hormone-related side effects(P < 0.05),which mainly were facial acne and pigmentation(P < 0.05). Among women with amenorrhea,the placement time was significantly longer and satisfaction rate was significantly higher in the treatment group than in the contraceptive group(P < 0.05). Conclusion:Different guiding strategies should be given to patients with different clinical applications of LNG-IUS,including detailed notification of various side effects before putting LNG-IUS,follow-up and timely treatment of various side reactions and complications,so as to reduce the rate of LNG-IUS extraction and improve the satisfaction rate of patients.

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李 甦,周德兰,孙 玮,梁佳乐,韩男男,杨颖倩,韩素萍.不同临床应用时左炔诺孕酮宫内缓释系统取出原因分析[J].南京医科大学学报(自然科学版),2019,(9):1331-1335

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  • 收稿日期:2019-01-04
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  • 在线发布日期: 2019-09-29
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