国际生殖健康/计划生育 ›› 2010, Vol. 29 ›› Issue (5): 336-337.

• 论著 • 上一篇    下一篇

宫腔镜下取出复杂性宫内节育器47 例临床分析

陈秀娟,李红,蔡良知   

  1. 350001 福州,福建省妇幼保健院
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2010-09-15 发布日期:2010-09-15

Removal of Complicated Intrauterine Contraceptive Device in 47 Cases under Hysteroscopy

CHEN Xiu-
juan,LI Hong,CAI Liang-zhi.   

  1. Fujian Provincial Maternal and Child Health Hospital,Fuzhou 350001,China
  • Received:1900-01-01 Revised:1900-01-01 Published:2010-09-15 Online:2010-09-15

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。

关键词: 宫内避孕器, 宫腔镜检查, 诊断, 超声检查, 腹腔镜检查

Abstract: 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鄄occupying lesions, uterine abnormalities, intrauterine
adhesions, ectopic ring, incarcerated, cracked and atrophy in postmenopausal uterus, which should be removed
IUD under hysteroscop and Type鄄B ultrasonic should be combined with if necessary.

Key words: Intrauterine devices, Hysteroscopy, Diagnosis, Ultrasonography, Laparoscopy