绝经期妇女IUD取出困难影响因素分析及防治探讨

Analysis on the influencing factors,and the prevention and treatment of difficult intrauterine device removal of menopausal women

目的:探讨绝经期妇女宫腔镜下宫内节育器(IUD)困难取出的影响因素及防治方法。方法:回顾性分析自2019年1月—2020年4月本院收治的231例行宫腔镜IUD取出术的绝经后妇女临床资料,分析取出困难影响因素。结果:231例均于宫腔镜直视下成功取出。包括89例金属圆环(38.5%)、70例T形IUD(30.3%)、42例V形IUD(18.2%)、30例其他类型(13.0%)。其中142例(61.5%)取出困难,分别为49例金属圆环(34.5%),53例T形IUD(37.3%),23例V形IUD(16.2%),17例其他类型(12.0%)。放置IUD时机为哺乳期和人工流产后、放置IUD年限、绝经年限、IUD类型是绝经后妇女取器困难的独立危险因素(P<0.05)。结论:重视计划生育避孕指导的宣教服务,缓解女性对取器手术的恐惧心理,督促其定期检查IUD,避免超期限使用IUD,提醒妇女绝经1年内适时取出IUD。

Objective:To explore the influencing factors,and the prevention and treatment of difficult hysteroscopic intrauterine device(IUD)removal of menopausal women.Methods:A retrospective analysis was conducted on 231 postmenopausal women who underwent hysteroscopic IUD removal from January 2019 to April 2020.The related influencing factors of difficult hysteroscopic IUD removal of these menopausal women were analyzed.Results:There were 231 women with IUD removal successfully by hysteroscopic direct vision,which included 89(38.5%)women with metal ring IUD,70(30.3%)women with T-shaped IUD,42(18.2%)women with V-shaped IUDs,and 30(13.0%)women with other types IUD.There were 89(38.5%)women with IUD removal smoothly.And 142 women with IUD removal difficultly,which included 49(34.5%)women with metal ring IUD,53(37.3%)women with T-shaped IUD,23(16.2%)women with V-shaped IUDs,and 17(12.0%)women with other types IUD.IUD inserted during lactation or immediately after induced abortion,the duration of IUD used,the duration of menopause,and the types of IUD were the independent risk factors of difficulty IUD removal of the postmenopausal women(P<0.05).Conclusion:The publicity and education on family planning and contraception should be paid attention to,so as to alleviating the fears on IUD removal of the postmenopausal women.And the position of the IUD of the women should be examined regularly,IUD used beyond the prescribed period should be avoided,and IUD of the women should be removed within one year after menopause.