目的观察米非司酮联合米索前列醇药物流产后早期和延迟放置宫内节育器(IUD)的安全性和有效性。方法210例需行药物流产的妇女以1︰2比例随机分配到早期放置组和延迟放置组,早期组(74例)于药流后7~10 d放置IUD,延迟组(136例)于4⁶周放置,术后随访半年并观察记录脱落、感染、出血等不良反应。结果两组IUD脱落率分别为5.5%和8.5%(P>0.05),因症取环率为10.9%和1.7%,早期组高于延迟组(P<0.05)。出血、疼痛和月经异常等不良反应两组接近,均未发生子宫穿孔、感染、带器妊娠。结论药物流产后早期放置IUD安全可靠,但最佳放置时间仍需进一步研究。

Objective To evaluate the safety,effectiveness of early and delayed IUD insertion after medical abortions with mifepristone and misoprostol. Methods 210 women who need medical abortion were divided into early group and delayed group in 1:2proportion randomly. The early group(n = 74) inserted IUD within 7 to 10 days after abortion and delayed group(n = 136) after 4-6weeks. IUD expulsion,infection,bleeding and other adverse reactions were documented until six months. Results The IUD expulsion rates were 5. 5% and 8. 5%(P > 0. 05). IUD removal rates due to side effects were 10. 9% and 1. 7% respectively,the early group higher than delayed group(P < 0. 05). Adverse effects about bleeding,pain and menstrual disorders were similar in two groups. No uterine perforation,infection,pregnancy with IUD in situ was reported. Conclusion Early IUD insertion after medical abortion is safe and reliable,but the best insertion time points need to be further studied.