宫腔镜取环困难患者调查及原因分析  

Investigation on patients with difficult removal of intrauterine device by hysteroscopy and reason analysis

作　　者：黄琳娟[1] 李聪[1] 余琴[1] 

机构地区：[1]重庆医科大学附属第一医院妇科,重庆400000

出　　处：《现代医药卫生》2016年第8期1124-1126,共3页Journal of Modern Medicine & Health

基　　金：国家自然基金青年基金资助项目(81100399)

摘　　要：目的回顾性分析宫腔镜下取环患者的流行病学因素,发现困难取环的高危因素,以利于临床对取环方式的优化选择。方法选取该院2015年9~12月门诊宫腔镜下困难取环患者145例,统计患者的年龄构成、住址差异、绝经时限、取环原因,发现宫腔镜下取环的高危因素。结果所有患者均成功取环,无并发症发生。非主城区患者[57.24%（83/145）]较主城区患者[42.76%（62/145）]多,差异有统计学意义（P〈0.05）;宫腔镜下取环患者多集中在30~44岁[46.21%（67/145）];采用宫腔镜取环的绝经时段集中于绝经1~5年[35.29%（18/51）]和绝经10年以上[31.37%（16/51）]者;宫腔镜下取环的主要原因为绝经[35.17%（51/145）],其次为出血性疾病[28.28%（41/145）],再次为节育器嵌顿或断裂[20.69%（30/145）],最后为取环失败[15.86%（23/145）]。结论对于取环高危因素及可能并发内膜器质性病变的患者而言,宫腔镜优于临床传统的取环和盲视诊刮术,对于高危因素的患者推荐选择。Objective To retrospectively analyze the epidemiological factors in the patients with removal of the in-trauterine device（IUD）by hysteroscopy to find the high risk factors for difficult removal of IUD in order to optimize the clinical se-lection of IUD removal modes. Methods A total of 145 cases of hysteroscopic IUD removal in our hospital from September to December 2015 were collected. The age structure,address difference,time limit of menopause,causes of IUD removal were statistically analyzed for finding the high risk factors and guiding the clinical selection of IUD removal methods. Results All cases were successful in IUD removal without complications occurrence. The non-urban patients [57.24%（83/145）] were more than the urban patients[42.76%（62/145）],the difference was statistically significant（P〈0.05）;the patients with hysteroscopic IUD removal were concentrated in 30-44 years old [46.21%（67/145）];the time period for hysteroscopic IUD removal was concentrated in 1-5years after menopause[35.29%（18/51）] and more than 10 years after menopause[31.37%（16/51）];menopause[35.17%（51/145）]and hemorrhagic disease[28.28%（41/145）] were the most common factors,followed by IUD incarceration or breakage[20.69%（30/145）],finally was the failure of IUD removal. Conclusion For the patients with high risk factors and the possibility of complicating endometrial lesions,hysteroscopy is better than the clinical traditional removal and blind curretage,which are recommended and selected for the patients with high risk factors.

关 键 词：宫内避孕器排出 宫腔镜 绝经后期 数据收集 

分 类 号：R169.41[医药卫生—公共卫生与预防医学]