摘要目的 探讨重复性剖宫产术中放置吉娜宫内节育器的效果和安全性。方法 选取2018年10月—2019年10月阳江市妇幼保健院收治的98 例重复性剖宫产患者作为研究对象，按照随机数字表法分为对照组（49 例）和研究组（49 例）。对照组术中未应用节育器，研究组术中采用吉娜宫内节育器。比较两组患者感染、腰骶疼痛发生率，半年妊娠率，术中出血量，术后2、24 h 总出血量，恶露持续时间，血性恶露持续时间，S-S 距离及并发症发生情况。结果 两组的感染、腰骶疼痛发生率比较，差异无统计学意义（P＞0.05）。研究组半年妊娠率低于对照组，差异有统计学意义（P＜0.05）；两组的术中出血量、术后2、24 h 总出血量、恶露持续时间、血性恶露持续时间比较，差异无统计学意义（P＞0.05）。产后42 d 时，研究组失访4 例，其余45 例产妇的吉娜环均在位，S-S 距离1.4～2.2 cm 的占比为75.6%；产后90 d 时，随访人数为40 例，吉娜环均在位，S-S 距离1.4～2.2 cm 的占比为72.5%；产后180 d 时，随访人数为37 例，吉娜环均在位，S-S 距离1.4～2.2 cm 的占比为81.1%；产后1年，随访人数为35 例，吉娜环均在位，S-S 距离1.4～2.2 cm 的占比为82.9%。产后42 d 研究组产妇无明显不适；产后90 d，14 例产妇主诉不适，占比28.6%，产后180 d，7 例产妇主诉不适，占比14.3%。结论 重复性剖宫产术中放置吉娜宫内节育器效果较好，是简单、安全、有效的避孕方法。
Abstract：Objective To investigate the effect and safety of Gina intrauterine device(IUD)in repeated cesarean section.Methods A total of 98 patients with repeated cesarean section admitted to Maternal and Child Health Hospital of Yangjiang from October 2018 to October 2019 were selected as the research objects,and were divided into a control group(n=49)and a study group(n=49)according to random number table method.The control group did not use the IUD during the operation,and the study group used the Gina IUD during the operation.The incidence of infection,lumbosacral pain,half-year pregnancy rate,intraoperative blood loss,postoperative 2 and 24 h total blood loss,lochia duration,lochia rubra duration,S-S distance and the incidence of complications in two groups were compared.Results There was no significant difference in the incidence of infection and lumbosacral pain between the two groups(P＞0.05).The pregnancy rate in the study group was lower than that in the control group,the difference was statistically significant(P<0.05).There were no significant differences in intraoperative blood loss,postoperative 2 h and 24 h total blood loss,lochia duration and lochia rubra duration between the two groups(P>0.05).On postpartum day 42,4 cases were lost to the study group,and Gina rings of the remaining 45 cases were all in place,with the S-S distance of 1.4-2.2 cm accounting for 75.6%.On postpartum day 90,40 patients were followed up,Gina rings of them were all in place,and the S-S distance of 1.4-2.2 cm accounting for 72.5%.On postpartum day 180,37 patients were followed up,Gina rings of them were all in place,and the S-S distance of 1.4-2.2 cm accounting for 81.1%.At 1 year postpartum,35 patients were followed up,Gina rings of them were all in place,and the S-S distance of 1.4-2.2 cm accounting for 82.9%.On postpartum day 42,the women in the study group had no obvious discomfort.On postpartum day 90,14 patients complained of discomfort,accounting for 28.6%.On postpartum day 180,7 patients complained of discomfort,accounting for 14.3%.Conclusion Gina IUD placement in repetitive cesarean section has a better effect and is a simple,safe and effective contraceptive method.
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