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目的探讨围绝经期宫内节育器(IUD)滞留的安全性。方法采用分层整群随机抽样方法,对围绝经期IUD滞留妇女612例和围绝经期非IUD避孕538例进行生殖健康和围绝经期症状问卷调查及相应的健康检查,采用Logistic多元回归方法对围绝经期IUD组与IUD滞留相关因素进行分析。结果IUD组与非IUD组比较,IUD组可以降低月经周期不规则的发生比例,腰腹疼症状IUD组明显高于非IUD组,附件炎发生比例低于非IUD组,子宫肌瘤或肥大发生比例IUD组低于非IUD组,对经期和痛经的影响随着放置IUD的时间延长明显下降,差异均有统计学意义(P<0.05);不同种类IUD对月经周期、经期、经量和痛经的影响差异有统计学意义(P<0.05);2组经量、痛经和经期,围绝经期症状,阴道炎和宫颈糜烂发生比例,血红蛋白水平比较,差异无统计学意义(P>0.05);但不同IUD种类对围绝经期妇女的月经异常有一定影响。多因素分析显示,放置IUD不同年限对月经周期、经量无显著性影响(P>0.05)。结论围绝经期IUD滞留未增加月经改变、围绝经期症状、妇科疾病及贫血的发生,应对围绝经期妇女IUD种类的匹配情况做进一步研究。
Objective To investigate the safety of perimenopausal IUD retention. Methods A stratified cluster random sampling method was used to investigate the reproductive health and perimenopausal symptoms of 612 cases of peri-menopausal women with IUD retention and 538 cases of peri-menopausal non-IUD contraception, and the corresponding health check-ups were conducted by Logistic multiple regression analysis Peri-menopausal IUD group and IUD retention related factors were analyzed. Results Compared with non-IUD group, IUD group could reduce the incidence of irregular menstrual cycle, the symptoms of lumbar and abdominal pain were significantly higher in IUD group than in non-IUD group, and the incidence of annex inflammation was lower than that in non-IUD group, uterine fibroids or hypertrophy The proportion of IUD group was lower than that of non-IUD group, and the influence on menstrual period and dysmenorrhea was significantly decreased with the prolongation of IUD placement (P <0.05). Different types of IUD had significant influence on menstrual cycle, menstrual period, menstrual flow and dysmenorrhea (P <0.05). There was no significant difference between the two groups in the amount of menstrual flow, menorrhagia and menopause symptoms, the incidence of vaginitis and cervical erosion, and hemoglobin level (P> 0.05). However, different IUD types have some impact on menstrual abnormalities in perimenopausal women. Multivariate analysis showed that there was no significant difference in menstrual cycle and the amount of menstrual flow between different years of placement of IUD (P> 0.05). Conclusions Peri-menopausal IUD retention did not increase menstrual changes, perimenopausal symptoms, gynecological diseases and anemia, and should be further studied on the matching of IUD types in perimenopausal women.