门诊宫腔镜联合腹部超声在节育器取出困难中的价值  

The value of outpatient hysteroscopy combined with abdominal ultrasound in difficulty of removing the Intra Uterine Device

作　　者：刘维香 LIU Weixiang(Department of Gynecology and Obstetrics,Xiangzhou Second People's Hospital,Zhuhai 519060,China)

机构地区：[1]广东省珠海市香洲区第二人民医院妇产科,广东珠海519060

出　　处：《中国医药科学》2019年第5期123-125,135,共4页China Medicine And Pharmacy

摘　　要：目的研究分析门诊宫腔镜联合腹部超声在节育器取出困难中的应用价值。方法本研究中的观察对象均为本院收治的节育器取出困难患者,选择2016年4月～2018年1月84例患者开展门诊宫腔镜联合腹部超声检查,对节育器位置、节育器同子宫肌层之间的关系等进行全面的了解。除此之外,将上述84例患者根据单双号分组的方式分为两组,每组42例,对照组患者均接受门诊宫腔镜取环,观察组则在其基础上联合腹部超声取环,比较两组患者的手术指标、疼痛程度以及术后并发症发生情况。结果对导致节育器取出困难的因素进行分析,发现诸多因素当中,嵌顿、残留断裂占比、绝经后宫颈萎缩占比均较高,宫腔粘连占比、异位占比以及黏膜下肌瘤占比相对而言较低;观察组患者的手术耗时与手术出血量均明显少于对照组,其疼痛评分以及术后并发症发生率均明显低于对照组,差异有统计学意义(P <0.05)。结论节育器发生嵌顿及断裂残留等均为导致节育器取出困难的主要因素,门诊宫腔镜联合腹部超声在节育器取出困难中应用,可以通过直接检查患者宫腔内环情况,对取环的方式进行选择,以提升取环的成功率。Objective To study the value of outpatient hysteroscopy combined with abdominal ultrasound in the difficulty of removing the Intra Uterine Device(IUD). Methods A total of 84 patients with difficulty in removing the IUD who admitted to the outpatient hysteroscopy from April 2016 to January 2018 were divided into an observation group and a control group,with 42 cases in each group.The control group underwent hysteroscopy IUD removal operation in the outpatient department,and the observation group was further combined with abdominal ultrasound on the basis of the observation.The above patients were examined by outpatient hysteroscopy combined with abdominal ultrasound,so that they had a full understanding of the location of IUD and the relationship between IUD and myometrium.Surgical indexes,pain degree and postoperative complications were compared between the two groups. Results By analyzing the factors leading to the difficult removal of IUD,it was found that the proportion of incarceration,residual fracture and post-menopausal cervical atrophy were higher among various factors,the proportions of uterine adhesion,ectopic and submucosal fibroids were relatively low.The operation time and blood loss in the observation group were significantly less than those in the control group,and the pain score and the incidence of postoperative complications in the observation group were significantly lower than those in the control group (P<0.05). Conclusion Incarceration and fracture residue of the IUD are the main factors leading to the difficulty of removing the IUD.Outpatient hysteroscopy combined application of abdominal ultrasound in the synthetic out difficulties,can be directly check in patients with an IUD, choose to take out the synthetic way,to improve the success rate of take out IUD.

关 键 词：宫腔镜 腹部超声 节育器 疼痛程度 

分 类 号：R713[医药卫生—妇产科学]