国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2013, Vol. 32 ›› Issue (1): 71-74.

• 综述 • 上一篇    

宫内节育器异位及其诊断


王 琨, 邹 燕, 楚光华   

  1. 100081 北京协和医学院研究生院（王 琨，楚光华）；国家人口计生委科学技术研究所（王 琨，邹 燕，楚光华）
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2013-01-15 发布日期:2013-01-15
  • 通讯作者: 邹 燕

Misplaced Intrauterine Devices and Diagnosis

WANG Kun，ZOU Yan，CHU Guang-hua   

  1. Peking Union Medical College Graduate School，Beijing 100730，China（WANG Kun，CHU Guang-hua）；National Research Institute for Family Planning，Beijing 100081，China（WANG Kun，ZOU Yan，CHU Guang-hua）
  • Received:1900-01-01 Revised:1900-01-01 Published:2013-01-15 Online:2013-01-15
  • Contact: ZOU Yan

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摘要： 宫内节育器（IUD）异位是放置IUD的并发症之一，其中子宫外异位较严重，甚至可危及生命。高危因素包括子宫特殊的生理状态、形态异常、子宫疾病和服务提供者经验不足等。因IUD异位的临床症状不明显，且不具特异性，故临床上IUD异位的诊断以辅助检查为主，其中超声及X线平片（透视）简便、费用低、非创伤，均可作为IUD异位的常规诊断手段，联合使用效果更好。电子计算机X线断层扫描技术（CT）检查费用昂贵，可作为一种可选择的补充诊断方法。宫腹腔镜可在直视下精确定位，但不适合单纯进行诊断，更适于在诊断的同时，取出异位的IUD。综述IUD异位的辅助诊断方法，并概述产生异位的原因、临床表现及相关知识，旨在提高基层计划生育服务提供者对诊断IUD异位的准确性，促进妇女群众生殖健康水平。

关键词: 宫内避孕器, 诊断, 超声检查, X线, 体层摄影术, 螺旋计算机, 腹腔镜, 宫腔镜

Abstract: Misplacement of intrauterine devices （IUDs） is one of the adverse complications of IUDs. Especially，locating outside of uterus is serious，even life-threatening. The risk factors of IUDs misplacement are the specific physiological status of uterus，abnormal shape，several diseases of uterus，as well as the absent experience of health workers. Clinical symptoms of IUDs misplacement are often unconspicuous and atypical. So，assistant examination is the main diagnosis method of misplaced IUDs. Sonography and ■ are convenient，low cost and nonintrusive，which can be used as the routine examination. The combination of sonography and x-ray can get better result. CT is an alternative method for its expensive cost. Both hysteroscope and laparoscope can make a definite diagnosis under direct vision， for removing the misplaced IUDs at the same time，but not for simple diagnosis. We discussed the diagnostic method，assistant examination，risk factors，clinical manifestation of misplaced IUDs，which are helpful for the service providers of primary family planning to diagnose accurately misplaced IUDs and to improve service level of reproductive health.

Key words: Intrauterine devices, Diagnosis, Ultrasonography, X-rays, Tomography, spiral computed, Laparoscopes, Hysteroscopes