Immediate insertion

立即插入
  • 文章类型: Journal Article
    本文旨在报告插入率的全面和最新的分析和证据,驱逐率,去除率,人工流产后立即放置宫内节育器(IUD)与延迟放置的使用率。PubMed,Embase,科克伦,WebofScience,CNKI,截至2024年1月12日,对万方数据库进行了全面搜索,以比较流产后立即插入宫内节育器与延迟插入宫内节育器的研究。评估指标包括手术或药物流产后插入宫内节育器的数量,6个月或1年驱逐和驱逐的频率,继续使用的次数,疼痛强度评分,感染的数量,出血的持续时间,以及宫内节育器插入期间或之后子宫穿孔的实例。十篇随机对照文章符合条件,包括11个研究项目,其中3个项目涉及手术流产后放置宫内节育器,8个项目涉及药物流产后放置宫内节育器。这包括2025名患者(立即插入组977名,延迟插入组1,048名)。我们总结了所有提取的证据。荟萃分析结果表明,对于术后流产,立即插入组的IUD放置率高于延迟插入组。医疗流产后,立即插入组显示出更高的宫内节育器放置率,利用率,并在6个月或1年时被驱逐。两组拔除率差异无统计学意义,插入后感染率,插入过程中的疼痛评分,以及随访期间出血天数。与延迟放置相比,立即插入宫内节育器不仅可以提高6个月或1年的使用率,还可以提高放置率。
    This article aims to report the comprehensive and up-to-date analysis and evidence of the insertion rate, expulsion rate, removal rate, and utilization rate of immediate placement of intrauterine devices (IUDs) versus delayed placement after artificial abortion. PubMed, Embase, Cochrane, Web of Science, CNKI, and Wanfang databases were comprehensively searched up to January 12, 2024 for studies that compared immediate versus delayed insertion of IUDs after abortion. The evaluation metrics included the number of IUD insertion after surgical or medical abortions, the frequency of expulsion and removal at 6 months or 1 year, the number of continued usage, pain intensity scores, the number of infections, the duration of bleeding, and instances of uterine perforation during or after IUD insertion. Ten randomized controlled articles were eligible, comprising 11 research projects, of which 3 projects involved the placement of an IUD after surgical abortion, and 8 projects involved the placement of an IUD after medical abortion. This included 2025 patients (977 in the immediate insertion group and 1,048 in the delayed insertion group). We summarized all the extracted evidence. The meta-analysis results indicated that for post-surgical abortions, the immediate insertion group exhibited a higher IUD placement rate than the delayed insertion group. After medical abortions, the immediate insertion group showed higher rates of IUD placement, utilization, and expulsion at 6 months or 1 year. The two groups showed no statistically significant differences in the removal rate, post-insertion infection rate, pain scores during insertion, and days of bleeding during the follow-up period. Compared to delayed placement, immediate insertion of IUDs can not only increase the usage rate at 6 months or 1 year but also enhance the placement rate.
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  • 文章类型: Journal Article
    Background: Immediate implant placement into extraction sockets has become a widely acceptable treatment option to decrease treatment time and enhance esthetics. The objectives of this study were to assess and compare the survival rates of immediate and delayed implant treatment as well as to investigate the effect of patient- and site-related variables on the treatment outcome in a large-scale population-based study. Methods: Dental records of patients who received implant therapy were retrieved from the electronic records of the University of Minnesota School of Dentistry. Demographic characteristics, dental insurance status, socioeconomic status as well as medical history and tobacco use were recorded. The treatment outcome was included as a binary variable (survival/failure). Time to failure (date of procedure to date of visit with failure) was compared between immediate and delayed implant treatment in Cox regression models. Kaplan−Meier plots for the survival of both treatment modalities were created. Patient-sites without failure were censored at the last follow-up visit. Results: A total of 4519 records of implants were included. The sample mean age was 60.27 years and included 50.7% males and 12.9% tobacco users. High socioeconomic status was characterized for 82.3% of the included population and 63.0% of them were self-payers. Immediate implants were significantly more frequently placed in the maxillary arch (p < 0.001) than in the mandible. Tobacco users received more often a delayed rather than an immediate implant placement (p = 0.001). The survival rate analysis revealed there were no significant differences between immediate and delayed implant placements (p = 0.48). The mean follow-up time was 32.27 months during which 1.5% immediate and 1.1% delayed implants were removed. The estimated mean survival time for immediate implants was 68.90 months, while delayed implants placed in healed sockets showed a mean survival time of 75.11 months. A statistically significant association was found between gender (p = 0.03) and osteoporosis (p = 0.001) with treatment outcome. Conclusions: The placement of immediate implants achieved similarly high survival rates when compared to delayed implants placed in healed sites. Males and osteoporotic individuals showed significantly higher implant failure than females and non-osteoporotic patients. This study demonstrated that both immediate and delayed implant placements are sound options with predictable treatment outcome.
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  • 文章类型: Journal Article
    背景:现代避孕药的可用性,包括长效可逆避孕药(LARC),是堕胎后护理的基本组成部分。南非最近一项随机对照试验(RCT)的结果比较了17-20孕周药物流产(MA)后立即插入和延迟插入铜宫内节育器(IUD)的结果,表明立即插入导致流产后6周使用更多的IUD。但驱逐率明显高于延迟插入。本研究旨在探索障碍,主持人,以及与孕中期药物流产后立即提供宫内节育器相关的特定环境因素。
    方法:我们与RCT一起进行了一项定性研究,其中我们对14名为研究参与者提供医疗保健的工作人员和24名研究参与者进行了深入访谈。研究问题探讨了立即插入宫内节育器的障碍和促进因素,避孕决策,以及背景和补充审判活动对服务提供的影响。访谈被记录和转录,如果需要,可以翻译成英语。我们在转录的访谈文本的水平上进行了三角主题分析。
    结果:研究护士在堕胎机构的避孕咨询提高了知识,纠正误解,流产后对宫内节育器的需求增加。妇女明确表示倾向于立即插入。方便,保护怀孕和隐私问题是最重要的,妇女表示倾向于与了解堕胎史的工作人员接触,他们和谁有既定的联系。医生和护士普遍赞成立即插入,并表示如果妇女愿意,可以将其纳入标准护理。这与研究小组需要采取干预措施以加强工作人员在试验期间分配的避孕药具的依从性形成鲜明对比。
    结论:妇女和工作人员赞成在孕中期药物流产后立即插入宫内节育器,但是服务提供可能需要确保堕胎后及时插入的结构,护理的连续性,沟通,减少对员工后续行动和培训的损失,以确保能力。
    BACKGROUND: The availability of modern contraception including long-acting reversible contraceptives (LARC), is a fundamental component of postabortion care. Findings from a recent randomized controlled trial (RCT) in South Africa comparing immediate to delayed insertion of the copper intrauterine device (IUD) after medical abortion (MA) at 17-20 gestational weeks showed that immediate insertion resulted in higher IUD use at 6 weeks postabortion, but that expulsion rates were significantly higher than for delayed insertion. This study aims to explore barriers, facilitators, and context-specific factors relevant to the implementation of immediate IUD provision after second trimester medical abortion.
    METHODS: We performed a qualitative study alongside the RCT in which we conducted in-depth interviews with 14 staff providing healthcare to study participants and 24 study participants. Research questions explored barriers and facilitators to implementation of immediate IUD insertion, contraceptive decision-making, and the impact of context and supplementary trial activities on service provision. Interviews were recorded and transcribed, with translation into English if needed. We performed a triangulated thematic analysis at the level of the transcribed interview text.
    RESULTS: Contraceptive counselling at the abortion facility by a study nurse improved knowledge, corrected misconceptions, and increased demand for the IUD postabortion. Women expressed a clear preference for immediate insertion. Convenience, protection from pregnancy and privacy issues were paramount and women expressed preference for engagement with staff who knew their abortion history, and with whom they had an established connection. Doctors and nurses were generally in favour of immediate insertion and said it could be incorporated into standard care if women wanted this. This contrasted with the need for interventions by the research team to reinforce adherence by staff to provide contraception as allocated during the trial.
    CONCLUSIONS: Women and staff favour immediate IUD insertion after second trimester medical abortion, but service delivery may require structures that ensure timely insertion postabortion, continuity of care, communication that mitigates loss to follow-up and training of staff to ensure competence.
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  • 文章类型: Journal Article
    目的:测试植入物失败率无差异的零假设,与在愈合部位插入相比,在新鲜拔牙槽中插入牙种植体的术后感染和边缘骨丢失,反对差异的替代假设。
    方法:组合使用的主要搜索术语:牙科植入物,口腔植入物,resh提取插座,立即安置,立即插入,立即植入。
    方法:2014年7月在PubMed进行了电子搜索,WebofScience,Cochrane口腔健康小组试验注册加上手工搜索。
    方法:合格标准包括临床人体研究,随机或不随机。
    结论:搜索策略产生了73种出版物,将8,241个植入物插入插座中(330个失败,4.00%),和19,410在愈合的部位(599个故障,3.09%)。建议在新鲜的拔牙槽中插入植入物会影响故障率(RR1.58,95%CI1.27-1.95,P<0.0001)。当评估插入上颌骨或下颌骨的植入物的研究被汇集时,差异没有统计学意义。或当使用植入物来修复全弓假体的患者的研究被汇集;然而,对于修复植入物支持的单冠患者的研究和对照研究具有重要意义.对术后感染的发生或边缘骨丢失的程度无明显影响。由于在纳入的研究中存在潜在的偏差和存在不受控制的混杂因素,因此应谨慎解释结果。他们中的大多数没有随机化。
    结论:在过去的几年中,直接植入物是否比放置在成熟骨中的植入物更容易失败的问题越来越受到关注。随着治疗理念的改变,定期审查不同的概念是必要的,以完善技术和消除不必要的程序。这将形成最佳治疗的基础。
    OBJECTIVE: To test the null hypothesis of no difference in the implant failure rates, postoperative infection and marginal bone loss for the insertion of dental implants in fresh extraction sockets compared to the insertion in healed sites, against the alternative hypothesis of a difference.
    METHODS: Main search terms used in combination: dental implant, oral implant, resh extraction socket, immediate placement, immediate insertion, immediate implant.
    METHODS: An electronic search was undertaken in July/2014, in PubMed, Web of Science, Cochrane Oral Health Group Trials Register plus hand-searching.
    METHODS: Eligibility criteria included clinical human studies, either randomized or not.
    CONCLUSIONS: The search strategy resulted in 73 publications, with 8,241 implants inserted in sockets (330 failures, 4.00%), and 19,410 in healed sites (599 failures, 3.09%). It is suggested that the insertion of implants in fresh extraction sockets affects the failure rates (RR 1.58, 95% CI 1.27-1.95, P<0.0001). The difference was not statistically significant when studies evaluating implants inserted in maxillae or in mandibles were pooled, or when the studies using implants to rehabilitate patients with full-arch prostheses were pooled; however, it was significant for the studies that rehabilitated patients with implant-supported single crowns and for the controlled studies. There was no apparent significant effect on the occurrence of postoperative infection or on the magnitude of marginal bone loss. The results should be interpreted with caution due to the potential for biases and to the presence of uncontrolled confounding factors in the included studies, most of them not randomized.
    CONCLUSIONS: The question whether immediate implants are more at risk for failure than implants placed in mature bone has received increasing attention in the last years. As the philosophies of treatment alter over time, a periodic review of the different concepts is necessary to refine techniques and eliminate unnecessary procedures. This would form a basis for optimum treatment.
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