尾丝断裂的吉妮宫内节育器取出的临床体会  

Clinical experience of removing tail-broken GyneFixIN IUD

作　　者：韩敏[1] 

机构地区：[1]东海县计划生育指导站,江苏连云港222300

出　　处：《齐齐哈尔医学院学报》2015年第27期4129-4131,共3页Journal of Qiqihar Medical University

摘　　要：目的探讨尾丝断裂的吉妮宫内节育器（IUD）取出方法的临床效果。方法选取2011至2014年来我站要求取出吉妮IUD并且均曾因于宫颈外牵拉尾丝造成尾丝断裂,扩宫困难,IUD无法取出的妇女168例,随机分为A、B两组,每组各84例。A组术前4~6小时阴道后穹窿放置米索前列醇600μg,取器全过程均在B超监测下进行,使用节育环取出钳取出IUD。B组术前4~6小时口服米索前列醇600μg,不用B超检测,使用血管钳取出IUD。观察两组宫颈软化,取器成功,手术时间和术中出血量以及药物的不良反应。结果两组宫颈软化差异无统计学意义（P〉0.05）。A组取器成功率高于B组,手术时间短于B组,术中出血量少于B组,两组比较差异有统计学意义（P〈0.05）。A组药物不良反应少于B组。结论对于尾丝断裂的吉妮IUD,术前阴道后穹窿放置米索前列醇,B超全程监测下使用节育环取出钳取IUD成功率高,手术时间短,术中出血少,不良反应小,值得推广。Objective To discuss the clinical efficacy of the methods of removing tail -broken GyneFixIN IUD.Methods Selected 168 female who visited our station during 2011and 2014 and required to remove GyneFixIN as research objects , they suffered GeneFlexIN/S and GeneFiexIN IUD failed due to the broken tail resulted from tail pulling outside cervix and difficulty of uterus dilatation .The subjects were randomized to group A with 84 patients and group B with 84 patients.Misoprostol 600ug was placed at the posterior fornix 4-6h before surgery for each patient in group A and the whole IUD removing process was conducted under B ultrasonic monitoring with IUD forceps .Patients in group B were given oral misoprostol 600ug 4-6h before surgery and the IUD removing process was conducted using vascular forceps without B ultrasonic monitoring .Observed the cervical softening, success rate of IUD removal, operative time, intra -operative blood loss as well as the adverse reactions of drugs .Results The condition of cervical softening in both groups presented no significant difference （P〉0.05）.In comparison with group B, group A had higher success rate of IUD removal , shorter operative time, less intra -operative blood loss and less adverse drug reactions , and the differences were statistically significant （P〈0.05）.Conclusions For tail-broken GyneFixIN, GeneFlexIN/S and GeneFiexIN IUD, the IUD removal procedure using IUD forceps with preoperative misoprostol placement at posterior fornix and B ultrasonic monitoring throughout the process presented higher success rate , shorter operative time , less intra-operative blood loss and less adverse reactions .This method is worthy of promotion .

关 键 词：宫内节育器 尾丝断裂 节育环取出钳 米索前列醇 

分 类 号：R169.41[医药卫生—公共卫生与预防医学]