宫腔镜下取出复杂性宫内节育器47例临床分析  

Removal of Complicated Intrauterine Contraceptive Device in 47 Cases under Hysteroscopy

作　　者：陈秀娟[1] 李红[1] 蔡良知[1] 

机构地区：[1]福建省妇幼保健院,福州350001

出　　处：《国际生殖健康／计划生育杂志》2010年第5期336-337,共2页Journal of International Reproductive Health/Family Planning

摘　　要：目的:探讨宫腔镜在取出复杂性宫内节育器(IUD)中的临床应用价值。方法:回顾性分析2006年1月—2009年12月因IUD并发症住院行宫腔镜取出的47例患者情况。结果:47例患者中IUD嵌顿17例,断裂8例,异位4例,断裂伴嵌顿16例,异位伴嵌顿2例。其中伴宫腔粘连6例。宫腔镜下取出42例,另5例IUD异位经宫腔镜检查明确诊断后,2例开腹取出,2例经腹腔镜取出,1例腹腔镜见IUD穿透子宫肌层进入乙状结肠并致密包裹粘连患者,经充分准备后开腹行肠粘连分离、取IUD、肠修补加子宫修补术。结论:采用宫腔镜取出复杂性IUD能直观其在宫腔内的情况,安全有效,具有诊断明确、手术成功率高、创伤小的优点。对有常规取IUD失败史、疑有IUD的异位、嵌顿、断裂者,应该在宫腔镜下取出,必要时配合超声取出。Objective：To probe into the clinical value of hysteroscopy in removal of complicated IUD.Methods：A retrospective analysis was carried out in 47 cases from January 2006 to December 2009 in our hospital with complications associated with IUD and removed IUD under hysteroscopy.Results：In 47 cases,IUDs of 42 cases were removed under Hysteroscopy including 17 cases of IUD embedded in the myometrium,8 cases of broken IUD,4 cases of ectopic IUD,16 cases of IUD fractured with incarceration,2 cases of ring fracture with incarceration and 6 cases of intrauterine adhesions.In 4 ectopic IUD cases,2 cases were removed by laparotomy and 2 cases removed under laparoscopy,respectively.Conclusions：Hysteroscopy used in removal of complicated IUD can provide direct observation intrauterine ring,and have the advantages of safety and effectiveness,clear diagnosis,high success rate and less trauma.Those cases that had been failed to be removed IUD conventionally or had uterine space-occupying lesions,uterine abnormalities,intrauterine adhesions,ectopic ring,incarcerated,cracked and atrophy in postmenopausal uterus,which should be removed IUD under hysteroscop and Type-B ultrasonic should be combined with if necessary.

关 键 词：宫内避孕器 宫腔镜检查 诊断 超声检查 腹腔镜检查 

分 类 号：R169.42[医药卫生—公共卫生与预防医学]