宫内节育器异位21例临床分析

The clinical analysis of 21 cases with intrauterine contraceptive device ectopia

目的:探讨宫内节育器(IUD)异位的诊治及预防措施。方法:回顾性分析2008年5月—2011年10月宫内节育器异位21例患者的临床资料。结果:21例中有6例为哺乳期上环,2例为人工流产后上环。宫内节育器深嵌入子宫肌层及浆肌层13例,异位于肠管5例,异位于阴道后穹窿1例,部分异位于大网膜1例,子宫肌瘤变性误诊为宫内节育器异位1例。21例患者术后均恢复良好。结论:宫内节育器异位的主要原因是操作者技术不熟练,上环过程中忽略患者主诉及术后未能严密随访所致;特殊时期(哺乳期、早孕流产、引产后)上环应警惕子宫穿孔;IUD异位无论有无症状一经确诊均应及早取出;绝经后妇女最好在绝经后半年至一年内取出;上环后应及时随访;应注重综合检查,选择适宜的手术方式,避免严重并发症;加强基层计划生育工作者的业务培训、诊断水平与责任感。

Objective：To study the diagnosis and preventive measures of intrauterine contraceptive device（IUD） ectopia.Methods：To analyze the clinical data of 21 cases with IUD ectopia from May 2008 to October 2011.Results：Ten cases of 21 cases ring in lactation,2 cases pregnancy with IUD in situ.The intrauterine contraceptive device of 13 cases embedded myometrium and plasma muscle,different is located in intestinal canal in 5 cases,and different is located in the vagina dome in 1 case,some different is located in the greater omentum in 1 cases,uterine fibroids degeneration misdiagnosed as IUD ectopia in 1 case.All patients recovered well after operation.Conclusion：The mian reason of intrauterine contraceptive device ectopia is the operator technology unskilled,ignoring patients during ring and no close postoperative follow-up.Special period （lactation,pregnancies after the abortion,after induced labor） ring should be vigilant the uterus perforation.IUD ectopia should early remove once diagnosed.Postmenopausal women should remove after menostasia.After the ring should be timely follow-up.Should pay attention to comprehensive inspection,choose the suitable operation method to avoid the severe complications.Strengthening primary family planning workers business training,diagnostic level and the sense of responsibility.