改良输卵管银夹节育效果的前瞻分析（附480例报告）.doc

改良输卵管银夹节育效果的前瞻分析（附480例报告） 【摘要】 目的观察经改良后输卵管银夹节育术的效果。方法改良夹在中山YZ-Ⅱ银夹的基础上对回钩与上夹臂接触距离及限钉高度加以改进，使用临床前瞻性研究法，事先设计好标准化表格备填，将对象随机分为两组。改良夹组480例，并与使用原夹组480例对照。结果使用原夹者3个月无复孕，6个月复孕2例，12个月复孕2例，24个月3例，36个月无复孕；改良后的银夹3、6个月无复孕，12个月复孕1例，24、36个月无复孕。两组对比差异有显著性（P0.05）。结论改良后的银夹绝育效果更加可靠。 【关键词】 计划生育 绝育 输卵管 银夹 Efficacy of modified silver clips in tubal sterilization： a report of 480 cases HUANG Wei-li，WANG Xiao-ling，CHEN Yu-zhi (Zhongshan Technological Service Center of Fammily Planning，Zhongshan，Guangdong 528400，P.R.China) Abstract： Objective To observe the clinical efficacy of modified sliver clips in tubal sterilization. Methods The modified sliver clips were obtained by improving the contact distance between the hook with the upper arm，and the restricted nails height as well basing on the Zhongshan type YZ-Ⅱ sliver clips.A prospective study was conducted.A standardized form was designed and the enrolled subjects were randomly allocated to two groups.A comparison of the modified clip group (n=480) to the original clip group (n=480) was performed. Results In the original clip group，none with recurrent pregnancy within 3 months，2 cases with recurrent pregnancy in 6 months，2 cases with recurrent pregnancy in 12 months，3 cases with recurrent pregnancy in 24 months，none with recurrent pregnancy in 36 months.In the modified clip group，none with recurrent pregnancy in 3 and 6 months，1 case with recurrent pregnancy in 12 months，none with recurrent pregnancy in 24 and 36 months.By comparison the data between these two groups，there were statistically differences (P0.05). Conclusion The efficacy is more reliable for modified silver clips in tubal sterilization. Key words： family planning; sterilization，tubal; silver clip 输卵管节育术是可靠性最高的避孕方法，远期失败率低于1%。输卵管银夹绝育术属于输卵管夹管外阻断法，具有操作简单、手术时间短、对象安全性大、痛苦少以及可逆性高等优点。中山YZ-Ⅱ型银夹为湖南银夹改进而来［1］，仍存在复孕率稍高等问题。我中心将由深圳市计生服务中心改进的中山YZ-Ⅱ型银夹（改良夹）应用于临床480例，并与使用中山YZ-Ⅱ型银夹（原夹）480例作前瞻性比较研究，现将结果报告如下。 1 资料与方法 1.1 银夹规格 本研究使用的为中山YZ-Ⅱ型银夹原夹与改良型中山YZ-Ⅱ银夹两种，规格对比见表1。 表1 改良夹与原夹的规格比较（略） 1.2 对象 年