纤维宫腔镜在迷路IUD诊治中的应用

The hystero-fiberscopic management in the difficult IUD removal.

目的:评价纤维宫腔镜在迷路宫内节育器诊断和治疗中的重要性。方法:应用Olympus HYF-1T纤维宫腔镜对因外院取器失败而就诊的48例妇女进行探查和治疗。结果:IUD嵌顿于宫角部8例,嵌顿于其它部位宫壁12例,断裂7例,残留12例,伴发宫腔粘连8例,宫颈管粘连6例,子宫肌瘤4例,子宫纵隔2例,子宫极度后屈1例,无明显原因3例,全部病例均取出宫内节育器,无并发症发生,效果满意。结论:由于纤维宫腔镜管径小,顺应性强,损伤小,同时视角多方位,探查及操作简便、安全、有效,有利于提高迷路IUD取出的成功率,具有较高的临床应用价值。

Objective: To assess the importance of flexible hysteroscope in complex removal procedure of IUD. Methods : Forty-eight women with the history of failed IUD removal or leaved part of IUD in uterus were treated by HYF-1T Hystero-Fiberscope under epidural anesthesia (less cases) or intravenous sedation (dolantin). Results: All of the cases were managed successfully by Hystero-Fiberscope ' HYF-IT' without complications: 8 cases with incarceration in the cornu of uterus. 12 cases with intramural incarceration. 14 cases with uterine or cervical cannel adhesion. 12 cases with the residue of IUD, 10 cases with the break of IUD, 4 cases with uterine myoma, I case with uterine malformation, another one just with uterine retroflexion. Only 3 cases without any problems, of course some cases with two or three complicated problems. Conclusions : Hystero-Fiberscope is safe and easy to use, and the operation can be performed directively and exactly for the neck and a thorough examination and difficult IUD removal, could be made properly.