宫腔镜下诊断和处理宫内节育环82例分析

Diagnosis and Management on 82 Cases of Intrauteric Contraceptive Rings with Hysteroscopy

目的：总结应用电视宫腔镜技术诊断和处理宫内节育器（IUD）并发症的经验。方法：2004年9月至2007年2月我院门诊行电视宫腔镜诊断1327例,诊断为IUD并发症82例。年龄24-70岁,平均46.7岁;行宫腔镜诊断前78例进行了B超检查。宫腔镜诊断和取出IUD同时进行。局部麻醉42例。静脉复合麻醉40例。结果：取出IUD的类型,金属O型IUD62例,其中IUD完整者17例,IUD断裂13例,IUD部分残留18例,IUD嵌顿11例,IUD移位于腹腔内3例。节育花环9例,其中取出完整节育花环6例,部分残留3例。硅胶盾形IUD6例。其中完整的4例,部分残留2例。其他类型IUD3例。IUD附件被误放入宫腔2例。结论：应用电视宫腔镜诊断和处理IUD并发症具有定位准确、创伤小、安全性高等优点。

Objective：To summary the diagnosis and management on complications of intrauterine device（IUD） with the hysteroscopy.Methods：Eighty-two patient aged 24-70 were diagnosed as IUD complications in the 1,327 outpatients totally with hysteroscopy in our hospital from September 2004 to February 2007.The average was 46.7 years old;78 of them had ultrasound examination before hysteroscopy.Diagnosis and removal of IUD with hysteroscopy were simultaneous.Forty-two cases were used local anesthesia,and the other 40 cases were balanced anesthesia.Results：The types of removed IUD,① 62 cases were O-shaped metal IUD,of which,17 with integrity,13 with fracture,18 with residue,11 with incarcerated,3 cases without intrauterine IUD and shifting into the intraperitoneal.②9 cases were flower type contraceptive rings.6 with integrity,3 with residue.③6 cases were shield-shaped silicone IUD.4 cases with integrity,2 cases with residue.④other types were 3.⑤2 accompanimens were put into uterine by mistaking.Conclusion：Hysteroscopy may help to accurate location,less trauma and safer for diagnosis and management of complications of intrauteric device.