宫腔镜在诊治宫内节育器取出困难中的应用  

The Application of Hysteroscopy for Solving the Failure in Routine Extraction of IUDs.

作　　者：冯缵冲[1] 黄玉莲[1] 杨邦元[2] 孙菊芳[2] 

机构地区：[1]上海市计划生育科学研究所,200032 [2]中国福利会国际和平妇幼保健院

出　　处：《中国计划生育学杂志》1994年第1期28-30,61-64,共6页Chinese Journal of Family Planning

摘　　要：本文介绍274例常规取节育器困难或失败的病例,经宫腔镜检查定位,274例中有237例病人的宫内节育器或其残段碎片在宫腔内,37例未见宫内节育器。237例中经此成功取出236例(用鳄鱼嘴型异物钳取出132,蟹爪异物钳取出86例.定位后用卵圆钳或长弯钳钳取出16例,微型钩取出3例),其取器成功率:99.58％;37例宫内未见节育器者也作出诊断(节育器脱落13例,环丝残留肌壁间2例)和相应的处理(腹腔镜取器14例,剖腹取器8例)。由此认为应用宫腔镜检查,必要时联合腹部B超或腹腔镜检查,籍以诊断和处理断裂或嵌顿等难以取出的宫内节育器是值得推荐的方法。In the present study 274 cases of IUD removal failure were examined with hysteroscopy. In 237 out of 274 IUDs fragments of IUD were detected in uterine cavity. The IUDs or broken fragments of IUD were removed successfully in 236 cases under hysteroscopy,with Crocodile-like forceps in 132 cases,with Crab-like forceps in 186,with mini-hook in 3 and with oval or Kelly's forceps in 16. Among the 37 women where IUDs were not found in uterine cavity, 13 cases had actual the expulsion of I-UDs,2 cases had small broken fragment of IUDs embedded in the uterine wall. In 22 cases the IUDs were found extrauterine and were removed by la-paroscopy in 14 cases and by laparotomy in 8 cases. The result of the study showed that hysteroscopy, or sometimes in combinection with ultrasonic screening or laparoscopy ,has been proved to be useful in detection and management of broken fragment or embedded pieces of IUD.

关 键 词：宫腔镜 诊治 IUD取出困难 

分 类 号：R169.41[医药卫生—公共卫生与预防医学]