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[荷兰全科医生学院“宫内节育器”实践指南总结]

[Summary of the practice guideline 'The intrauterine device' from the Dutch College of General Practitioners].

作者信息

Boukes Froukje S, Kertzman Maud G M, Smeenk Rob C J, Goudswaard A N Lex

机构信息

Nederlands Huisartsen Genootschap, afd. Richtlijnontwikkeling en Wetenschap, Utrecht, The Netherlands.

出版信息

Ned Tijdschr Geneeskd. 2009;153:A578.

Abstract

The practice guideline 'The intrauterine device' from the Dutch College of General Practitioners, first published in 2000, has been revised. Copper and hormonal IUDs have more or less the same level of reliability with respect to preventing pregnancy. During the use of a copper IUD, menstruation tends to be longer with a greater loss of blood; in 70% of women who use a hormonal IUD oligomenorrhea or even amenorrhoea develops. Women with a history of venous thromboembolism can use a hormonal IUD safely. In the first weeks after IUD insertion, there is an increased risk of pelvic inflammatory disease (PID). Therefore prior to insertion, the general practitioner should enquire about the risk of a SOA being present and, if necessary, perform SOA tests. In the Netherlands, IUD insertion can usually be performed at a general practice.

摘要

荷兰全科医生学院于2000年首次发布的实践指南《宫内节育器》已修订。在预防怀孕方面,铜离子宫内节育器和激素宫内节育器的可靠性大致相同。使用铜离子宫内节育器期间,月经往往会延长,失血量更大;70%使用激素宫内节育器的女性会出现月经过少甚至闭经。有静脉血栓栓塞病史的女性可以安全使用激素宫内节育器。在宫内节育器插入后的最初几周内,盆腔炎(PID)风险增加。因此,在插入前,全科医生应询问是否存在性传播感染的风险,必要时进行性传播感染检测。在荷兰,宫内节育器插入通常可在全科诊所进行。

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