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目的:探讨不同状态子宫内膜对不同宫内节育器(IUD)的临床反应。方法:应用子宫内膜细胞采集器在募集对象放置宫内节育器时采取子宫内膜组织制片,样本集中寄往北京大学附属医院妇产科宫腔细胞学检测中心统一专人阅片。结果:普通人群与高危因素人群对比,术前子宫内膜细胞良性增生性改变及不典型增生性改变发生率差异均有统计学意义(P<0.05),术后常见不良反应发生率差异均无统计学意义(P>0.05);术前子宫内膜状态为良性增生性改变及与不典型增生性改变的人群放置IUD后不良反应发生率明显高于未见异常细胞人群(P<0.01);不同类型IUD人群术前子宫内膜细胞学诊断两两对比差异无统计学意义(P>0.05);各种节育器术后常见不良反应两两对比,复合γ环与普通活性γ环的子宫异常出血发生率差异有统计学意义(P<0.05),其余无统计学意义。结论:放置IUD时子宫内膜细胞学检测可以了解受术者术前内膜细胞状态,评估其对IUD的初步适应性,可帮助诊治术后不良反应,还可以在无症状的人群中发现子宫内膜疾病,为IUD的安全有效应用提供科学依据。对于术后不良反应人群还可以作为一种跟踪监测措施,适时应用和评估IUD对子宫内膜的影响,科学指导临床诊断和治疗。
Objective: To investigate the clinical response of different status endometrium to different intrauterine devices (IUD). Methods: The endometrial cell harvester was used to collect the endometrial tissue when the IUD was collected. The samples were collected and sent to the Central Hospital of Peking University Obstetrics and Gynecology Uterine Cytology Test Center unified reading. Results: There were significant differences in the incidences of benign proliferative and atypical hyperplastic changes of preoperative endometrial cells between the general population and the high risk group (P <0.05), and there was no difference in the incidence of common adverse reactions (P> 0.05). The incidence of adverse reactions was significantly higher in IUD group than in those without abnormal cell population (P <0.01) after benign prostatic hyperplasia and dysplasia. There was no significant difference in preoperative endometrial cytological diagnosis between different types of IUDs (P> 0.05); adverse reactions in all kinds of IUDs were compared with each other, the uterus between the composite γ-ring and common active γ-ring Bleeding rate was significantly different (P <0.05), the rest was not statistically significant. CONCLUSION: Endometrial cytology in IUD allows us to know the status of preoperative endometrial cells, assess their initial adaptability to IUD, and to help diagnose and treat postoperative adverse reactions. Uterus can also be found in asymptomatic people Intimal diseases, IUD for the safe and effective application of scientific basis. For postoperative adverse reactions, the population can also be used as a follow-up monitoring measures, timely application and assessment of the impact of IUD on the endometrium, scientific guidance in clinical diagnosis and treatment.