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宫内节育器(IUD)置入后的细胞学研究(作者译)

[Cytologic studies after insertion of intrauterine contraceptive devices (IUD) (author's transl)].

作者信息

Prinz W, Noack J, Kraus H, Schuhmann R A

出版信息

Geburtshilfe Frauenheilkd. 1981 Mar;41(3):194-8. doi: 10.1055/s-2008-1037354.

Abstract

Cervical smears of 554 women using IUDs were examined. The following criteria were evaluated: 1. Age distribution, 2. maturation index of the vaginal epithelium, 3. vaginal flora, 4. cytologic criteria of inflammation, 5. period of time between insertion of the IUD and the cytological examination, 6. final cytologic diagnosis. 554 women without IUD and normal gynaecological status served as a control group. It was the goal of the study to find out, firstly if IUDs in situ produce typical and specific changes in the cytologic pattern and secondly if the rate of suspicious and positive findings is increased: In IUD using women the rate of cases with unphysiologic vaginal flora is increased, the rate of inflammatory cytologic specimen is also higher than in the control group. The rate of inflammatory smears decreases with the increasing interval of time between insertion and cytological examination. IUD typical changes could be observed only in so far as in this group the cytologic signs of chronic cervicitis were increased. Inflammatory alterations are the reason for the higher rate of "suspicious" smears in the group of IUD-users. There was no higher rate of praecancerous lesions among the IUD users. The importance of these results for the clinical management are pointed out.

摘要

对554名使用宫内节育器(IUD)的女性的宫颈涂片进行了检查。评估了以下标准:1. 年龄分布;2. 阴道上皮成熟指数;3. 阴道菌群;4. 炎症的细胞学标准;5. 放置IUD与细胞学检查之间的时间间隔;6. 最终细胞学诊断。554名未使用IUD且妇科状况正常的女性作为对照组。本研究的目的是,首先确定原位IUD是否会在细胞学模式上产生典型和特定的变化,其次确定可疑和阳性结果的发生率是否增加:在使用IUD的女性中,非生理性阴道菌群的病例发生率增加,炎性细胞学标本的发生率也高于对照组。炎性涂片的发生率随着放置IUD与细胞学检查之间时间间隔的增加而降低。仅在该组慢性宫颈炎的细胞学征象增加的范围内观察到IUD典型变化。炎症改变是IUD使用者组中“可疑”涂片发生率较高的原因。IUD使用者中癌前病变的发生率没有更高。指出了这些结果对临床管理的重要性。

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