上海市宫腔镜下宫内节育器取出死亡病例分析  

Evaluation of Hysteroscopic-guided Removal of Intrauterine Device in Shanghai: A Report of 4 Dead Cases

作　　者：康建中[1] 刘晓瑷[1] 肖志琴[1] 黄咏梅[1] 吴愉[1] 程利南[1] 

机构地区：[1]中国福利会国际和平妇幼保健院上海市计划生育技术指导所,上海200030

出　　处：《生殖与避孕》2010年第4期258-262,共5页Reproduction and Contraception

摘　　要：目的:探讨宫腔镜下取出宫内节育器(IUD)手术的死亡原因,寻找提高宫腔镜下取器安全性的措施。方法:回顾性调查上海市87所医院2001.01.01～2007.12.31期间所有宫腔镜下IUD取出术11110例,其中意外死亡4例。结果:4个病例的死亡原因均为肺栓塞(空气栓塞)。与死亡相关的主要因素有:手术前准备不充分;2次手术时间间隔太短;手术操作不规范;术中观察不仔细;抢救不及时等。结论:建立与宫腔镜下手术配套的抢救设备、操作规范和提高医务人员临床经验资质是非常必要的。Objective： To analyze the possible causes leading to death from the hysteroscopic-guided intrauterine device （IUD） retrieval with a purpose to provide preventive measures to improve the safety. Methods： All cases （11 110） of IUD removal under hysteroscopy performed at 87 hospitals in Shanghai from 2001 to 2007 were reviewed. Four dead cases were reported. Results： Air embolism was suspected as the cause of death. Associated risk factors included insufficient preoperative preparation, short duration between surgeries, non-standard procedure, careless observation and untimely resuscitation. Conclusion： These case reports emphasize the necessity of establishing the standard guideline for hysteroscope-guided IUD removal, which includes early interventions taken such as prevention, early detection and management of the fatal complications and improving the qualification of operator.

关 键 词：宫腔镜 宫内节育器 静脉麻醉 死亡 抢救规范 

分 类 号：R713[医药卫生—妇产科学]