Cheng Linan, Steiner Markus J, Meng Haizhen, Luo Diane, Zhong Yi, Cheng Ying, Chen Guohu, Ni Hong, Feldblum Paul J
Shanghai Institute of Planned Parenthood Research (SIPPR); Shanghai, China.
FHI 360; Durham, NC 27701 USA.
Contraception. 2014 Sep;90(3):249-52. doi: 10.1016/j.contraception.2014.05.008. Epub 2014 May 20.
Complications during contraceptive implant removal are important for users and programs. We describe breakage rates during Sino-implant (II) removals at four Chinese family planning clinics.
We collected data by observation of consecutive removal cases and subsequent data transcription onto a standardized case report form. Three sites used the "pull out" removal technique, and one site used the "U" technique.
Sino-implant (II) rods were removed from 318 women. There were 16 implant breaks (5.0%), with the breakage rate varying by site from 0% to 7.4%. All 16 breaks occurred at the three sites that used the standard "pull out" technique. Six implants were cut by the scalpel, five were snapped by the clamp, and five were unspecified. Other contributing factors included deeper or wider positioning of the implants (n=6) and implants that were enveloped by thick fibrous tissue (n=3). There was no relationship between breakage rate and duration of implant use. Less than 1% of removals took more than 10 min.
Both the standard "pull out" technique as well as the "U" technique can be used to remove Sino-implant (II). Breakage during implant removal may not be problematic if all fragments of the rod are readily removable. Breakage occurs with predictable low frequency, and training is needed to assure that providers can deal with breakage events.
Contraceptive implant removal complications are important for users and programs. These are some of the first data on breakage during removal of Sino-implant (II). More than one removal technique can be used, but training is required to ensure that providers can deal with the infrequent implant breaks.
取出避孕植入物时出现的并发症对使用者和项目来说至关重要。我们描述了在中国四家计划生育诊所取出欣妈富隆（Ⅱ型）时的断裂率。
我们通过观察连续的取出病例并随后将数据转录到标准化病例报告表上来收集数据。三个地点使用“拔出”取出技术，一个地点使用“U形”技术。
从318名女性体内取出了欣妈富隆（Ⅱ型）棒。有16例植入物断裂（5.0%），断裂率在不同地点从0%到7.4%不等。所有16例断裂均发生在使用标准“拔出”技术的三个地点。6根植入物被手术刀切断，5根被夹子夹断，5根情况不明。其他促成因素包括植入物位置更深或更宽（n = 6）以及植入物被厚厚的纤维组织包裹（n = 3）。断裂率与植入物使用时间无关。不到1%的取出操作耗时超过10分钟。
标准“拔出”技术以及“U形”技术均可用于取出欣妈富隆（Ⅱ型）。如果棒的所有碎片都能轻易取出，植入物取出过程中的断裂可能不成问题。断裂发生的频率较低且可预测，需要进行培训以确保医护人员能够处理断裂事件。
避孕植入物取出并发症对使用者和项目来说很重要。这些是关于取出欣妈富隆（Ⅱ型）时断裂情况的首批数据之一。可以使用多种取出技术，但需要培训以确保医护人员能够处理罕见的植入物断裂情况。
