von Mering Ruth, Merki Gabriele S, Keller Paul J
Klinik für Endokrinologie, Departement Frauenheilkunde, Universitätsspital Zürich, Switzerland.
Gynakol Geburtshilfliche Rundsch. 2003 Jan;43(1):25-30. doi: 10.1159/000067166.
About 30% of women with completed family planning choose tubal ligation as a method of contraception. Contraceptive safety of tubal ligation, with a Pearl index of 0.18, is comparable to those of OC or modern intrauterine devices (IUD). Pregnancies that occur after tubal ligation are often ectopic, especially in young women. There is currently no evidence that tubal ligation causes menstrual abnormalities. The risk of breast cancer, cancer of the endometrium or cervix is not elevated after tubal ligation, whereas the risk of ovarian cancer is even reduced. The risk of post-sterilization regret is higher when the operation was performed in women with children aged younger than 30 years. Tubal ligation is recommendable for women over 35 years of age with completed family planning, especially if contraindications for the use of OC or IUD exist. In general, vasectomy should always be discussed as a possible alternative.
约30%完成计划生育的女性选择输卵管结扎作为避孕方法。输卵管结扎的避孕安全性(Pearl指数为0.18)与口服避孕药(OC)或现代宫内节育器(IUD)相当。输卵管结扎后发生的妊娠往往是异位妊娠,尤其是在年轻女性中。目前没有证据表明输卵管结扎会导致月经异常。输卵管结扎后乳腺癌、子宫内膜癌或宫颈癌的风险并未升高,而卵巢癌的风险甚至有所降低。在年龄小于30岁且有子女的女性中进行输卵管结扎手术时,绝育后后悔的风险更高。对于35岁以上完成计划生育的女性,尤其是存在使用OC或IUD的禁忌证时,推荐进行输卵管结扎。一般来说,输精管结扎术也应始终作为一种可能的替代方案进行讨论。