Abstract：
The Norplant implant system consists of 6 silastic capsules which deliver levonorgestrel to protect against pregnancy over 5 years. Clinical trials were conducted in 46 countries. The 5-year cumulative pregnancy rate is 3.9%. Norplant\'s efficacy falls as weight increases. Its failure rate is lower than that of combined oral contraceptives and most IUDs. Counseling is linked to acceptability. Medical personnel should be trained in counseling potential Norplant acceptors. They must undergo formal training in insertion and removal of Norplant. The first year and fifth year continuation rates are 75-90% and 25-78%, respectively. Bleeding irregularities are the main reason for discontinuation and the most commonly reported side effects. Levonorgestrel changes the cervical mucus and suppresses ovulation and the endometrium. Toxicological and teratological data on levonorgestrel and silastic show that Norplant is safe. It appears that Norplant does not cause any major pathological changes in the endometrium, liver, kidney, and adrenal and thyroid glands. Levonorgestrel in Norplant is linked to a slight increase in serum glucose levels which are not of significant consequence. Its effects on lipids and lipoproteins are not clear. Fertility returns to Norplant users shortly after removal. The return to fertility pattern basically matches that of other methods. Contraindications of Norplant use are confirmed or suspected pregnancy, previous ectopic pregnancy, breast cancer, cancer of the genital tract, cerebrovascular or coronary artery disease, acute liver disease, and undiagnosed abnormal genital bleeding. Norplant should be inserted subdermally in the upper arm during the first 7 days after menstruation begins. The capsules must be removed after 5 years if pregnancy is to be avoided. Before family planning programs provide Norplant, managers should make sure the staff is adequately prepared. Health personnel, counselors, potential users, and the public need informational materials on Norplant.
摘要：
Norplant植入系统由6个硅橡胶胶囊组成，可在5年内提供左炔诺孕酮以防止怀孕。临床试验在46个国家进行。5年累积妊娠率为3.9%。Norplant的功效随着体重的增加而下降。其失败率低于联合口服避孕药和大多数宫内节育器。咨询与可接受性有关。医务人员应接受咨询潜在的Norplant受体的培训。他们必须接受插入和移除Norplant的正式培训。第一年和第五年的延续率为75-90%和25-78%，分别。出血不规则性是停药的主要原因，也是最常见的副作用。左炔诺孕酮改变宫颈粘液，抑制排卵和子宫内膜。左炔诺孕酮和硅橡胶的毒理学和致畸数据表明Norplant是安全的。看来Norplant不会引起子宫内膜的任何重大病理变化，肝脏,肾,肾上腺和甲状腺.Norplant中的左炔诺孕酮与血清葡萄糖水平的轻微增加有关，但没有明显的后果。其对脂质和脂蛋白的影响尚不清楚。删除后不久，生育率又回到了Norplant用户。恢复生育模式与其他方法基本匹配。Norplant使用的禁忌症被确认或怀疑怀孕，以前的异位妊娠，乳腺癌,生殖道癌症,脑血管或冠状动脉疾病，急性肝病,和未确诊的异常生殖器出血.在月经开始后的前7天，应在上臂皮下插入Norplant。如果要避免怀孕，则必须在5年后取出胶囊。在计划生育计划提供Norplant之前，管理人员应确保员工做好充分准备。卫生人员,辅导员,潜在用户,公众需要Norplant的信息材料.
