长期置TCu220C IUD的子宫内膜宫腔镜及形态计量研究

The Hysteroscopical and Morphometric Study of Endometrium during Long-Term Use of TCu220C IUD.

对长期(5年以上)置TCu220C IUD对象作宫腔内直视检查,了解其长期安全性。方法:对68例带该器妇女,用宫腔镜检查,并取IUD压迹下及压迹1cm外子宫内膜作病理形态计量。结果:宫腔镜下观察到带器5年者压迹处内膜柔软,充血水肿明显,随带器时间延长,压迹处内膜变硬,粗糙,带器9年以上30例中有26例压迹处内膜质硬,局部充血水肿,并有出血。病理形态计量测定,带器5年之压迹处内膜以轻度慢性炎症为主;7年者腺体上皮轻度增生;9年以上则局部内膜破碎坏死,且见剥脱之铜屑,异物巨细胞反应。IUD 1cm外内膜正常。光镜下所见结果与宫腔镜观察相符。上述结果提示TCu220C IUD长期放置(10年以内)是安全的。

Audio-visual examination in the uterine cavity during long-term (over 5 years) use of TCu220C IUD was conducted for understanding of long-term safety. Method: 68 women using this IUD were examined by hysteroscopy and their endo-metric samples taken from site of IUD im-pressure and outsid 1 cm were observed by morphometer. Result : Observation by hysteroscopy—— Endometrium situated atIUD impressure for 5 years is soft.with obvious hyperemia and edema. It becomes hardening and rough along with time prolongation. Endometrium using IUD over 9 years (26/36 cases) is hard with local hyperemia,edema and hemorrhage. Pathological morphometric meassurement——Endometrium situated at IUD impressure for 5 years appears mainly with light chronic inflammation; using IUD for 7 years with glandular epithelium hyperplasia; using IUD for 9 years with destroction and necrosis,accompanied corroding copper filings and foreign body macrophagus reaction. Endometrium outside IUD 1cm is normal. Results of observation by microscopy is similar by hysteroscopy. As the mentioned above,long-term within 10 years using TCu220C IUD is safe.