Clinical Study On Changes Of Coagulation And Fibrinolytic System Induced By Etonogestrel Subcutaneous Implant

Objective:To investigate the effect of etonogestrel subcutaneous implant as a progesterone contraceptive agent on coagulation and fibrinolysis system and the risk of venous thrombosis,and to seek solutions to reduce the risk of venous thrombosis in women.Methods: A total of 32 healthy women with contraceptive requirements from January2017 to January 2018 were selected and placed in the department of obstetrics and gynecology of the second hospital of shanxi medical university with etonogestrel implant,and the changes in coagulation and fibrinolysis indexes were compared between the two groups before and after implantation at 1,3 and 6 months,and 1,3 and 6 months after implantation,analyze the risk of venous thrombosis.Preparetions telephone follow-up clinical symptoms of thrombosis after I return immediately do colour to exceed to exclude venous thrombus,for asymptomatic in preparetions 1,3 and 6 months after return to school regularly detection of blood coagulation and fibrinolytic system related indexes,such as part of the clotting enzyme live time(APTT),prothrombin time(PT),fibrinogen(FIB),D-Dimer(D-Dimer).Mean standard deviation was used to represent the measurement data in this study,and t test was used for comparison between the two groups.P < 0.05 was considered statistically significant.Results: None of the 32 women had venous thrombosis,but the indicators of coagulation and fibrinolysis were significantly changed.Pairwise comparison of the implantation agent1,3 and 6 months with that before implantation showed that PT and APTT were significantly reduced,and the difference was statistically significant(P < 0.05).Pairwise comparison of PT and APTT at 1,3 and 6 months after implantation showed statistically significant difference(P < 0.05).There was no significant difference between PT and APTT at 3 and 6 months after implantation(P > 0.05).After implantation,FIB and d-dimer were significantly higher at 1,3 and 6 months than before implantation,and FIB was significantly higher at 1,3 months than before implantation(P < 0.05).The difference of FIB between 3 months and 6 months after implantation and between 1 month and 6 months after implantation was statistically significant(P<0.05).There was no significant difference between 1 month and 3 months after implantation(P>0.05).D-dimer was significantly increased in pairwise comparison between 1,3,and 6 months after implantation and that before implantation,and the difference was statistically significant(P<0.05);there was no statistically significant difference in pairwise comparison of d-dimer between 1,3,and 6 months after implantation(P>0.05).Conclusion:(1)The changes of coagulation and fibrinolysis were induced by Etopodiene subcutaneously,but they all fluctuated within the normal range.(2)The changes of coagulation and fibrinolysis indexes caused by etogestelline subcutaneous implantation were obvious in the first month of implantation,and the fluctuation range of coagulation and fibrinolysis indexes was small gradually with the extension of implantation time.(3)In clinical practice,the risk of venous thrombosis caused by etopogestrel implant is very small.