摘要
目的探讨宫腔镜、腹腔镜技术在困难节育器(IUD)取出中的应用价值。方法 2001年～2010年,对常规取器失败的244例均经B超、X线、宫腔镜检查后,选择相应的宫腔镜和腹腔镜进行手术治疗。结果困难IUD中部分嵌顿146例,断裂、残留71例,盆腹腔异位27例。其中12例合并子宫肌瘤使IUD扭曲变形。嵌顿的146例中宫腔镜取出120例,腹腔镜取出20例,另6例腹腔镜监护下经宫腔镜取出;71例断裂残留IUD中宫腔镜取出66例,1例腹腔镜取出,另4例腹腔镜监护下经宫腔镜取出;27例盆腹腔异位IUD中,25例在腹腔镜下取出,2例中转开腹。5例肠管损伤,均为IUD嵌入肠管浆肌层,其中1例开腹修补,4例在腹腔镜下修补。结论宫腔镜、腹腔镜能直视宫腔和盆腹腔情况,取出困难IUD,达到治疗目的,安全性高。
Objective To investigate the application of hysteroscopy and laparoscopy in difficult IUD removal. MethodsWe performed hysteroscopic and laparoscopic surgery for 244 cases who failed in routine IUD removal from 2001 to 2010.All the patients received the surgery after being examined by B-ultrasonography,X-ray,and hysteroscopy.Results The difficult IUD included partial incarceration（146 patients）,fracture and residual（71 cases）,and ectopia（27 cases）.In the cases,contraceptive ring distortion was caused by uterine fibroids in 12 patients.In the 146 cases of partial incarceration,the incarcerated IUD was removed by hysteroscopy in 120 cases,by laparoscopy in 20 cases,and by hysteroscopy under the guidance by laparoscopy in the other 6.In the 71 cases of fracture or residual cases,the IUD was removed by hysteroscopy in 66 patients,by laparoscopy in 1,and by laparoscopy combined with hysteroscopy in the other 4.In the ectopic cases,25 were cured by laparscopy,2 were converted to open surgery.Totally 5 patients had intestinal injury during the operation,which was due to incarceration of the IUD into the seromuscular layer,one of them were cured by open surgical repair,and the others were repaired by laparoscopy. Conclusion Hysteroscopy and laparoscopy provide a direct view of the uterine and abdominal cavities,which is helpful and safe for removing difficult IUD.
出处
《中国微创外科杂志》
CSCD
2011年第10期906-908,共3页
Chinese Journal of Minimally Invasive Surgery
关键词
宫腔镜
腹腔镜
困难节育器
Hysteroscopy
Laparoscopy
Difficult IUD
