[目的]探讨再次剖宫产术中放置吉娜固定式宫内节育器（IUD）的临床效果。[方法]随机选取2011年2月1日至2013年2月28日湖州市妇幼保健院住院中初次剖宫产者100例（A组）、再次剖宫产妇女100例（B组）为观察组，随机选取同期剖宫产妇女100例（C组）作为对照组。A组、B组在剖宫术后立即放置吉娜IUD，C组术中不放置吉娜IUD，术后使用避孕套避孕，比较3组术后24h内出血量、产褥病率发生情况、产后血性恶露持续时间，随访比较A、B组1年内节育器的脱落率、因症终止率，3组间的妊娠率、副反应如月经异常、痛经等的发生率等。[结果]A、B组比较，24h内阴道出血量、血性恶露天数、产褥病率差异无统计学意义（P>0.05）。B组和C组比较，24h内阴道出血量、血性恶露天数、产褥病率组间差异也无统计学意义（P>0.05）。随访结果，A、B两组的节育器脱落、妊娠和因症取出率、副反应发生率无显著性差异（P>0.05）,B、C两组间妊娠率和副反应的发生也无显著性差异（P>0.05）。[结论]无论是初次剖宫产还是再次剖宫产，使用吉娜IUD都是安全有效的。%Objective] To discuss the clinical effect of placing Gina IUD for re-cesarean section. [Method] Randomly select 100 cases(group A) from FebH, 2011 to Feb. 28, 2011 of first cesarean section, and 100 cases of re-cesarean section(group B), and another 100 cases cesarean section in the same term as control group(C). Place Gina IUD for groups A and B, not in C; take condom for birth control after operation; compare 3 groups' 24-h bleeding amount, puerperalism and postpartum bloody lyma continual period; fol ow up and compare groups A and B's 1-year expulsion rate, termination rate owing to Gina IUD, pregnancy rate, side effects(abnormal menstruation) and dysmenorrheal rate, etc. [Result] In groups A and B, there's no statistical meaning of difference on 24h vaginal bleeding amount, bloody lyma days and puerperalism; so for groups B and C. After being fol owed up, in groups A and B, there's no marked difference on IUD expulsion, pregnancy and taking-out rate over symptoms and side effects rate, so for groups B and C. [Conclusion] No matter it is first cesarean section or re-cesarean section, placing Gina IUD is safe and effective.
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