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对我院 1991年至 1998年住院 13例宫内节育器 (Intrauterine Contraceptive Device ,IUD)异位的分析发现 ,怀疑 IU D异位的主要原因为带器妊娠取环失败 (8/ 13)。 IUD异位的诊断及定位需综合应用腹部 B超、盆腔 X线、宫腔镜及腹腔镜等检查手段。异位分类中 5例为子宫肌壁嵌顿 ,其中单纯经宫腔镜手术 3例取出完整 IU D,1例取出部分断裂的 IUD而遗留少许于子宫壁内 ,1例经开腹取出因断裂而完全嵌顿于肌壁间的 IUD;8例为腹腔异位 ,经腹腔镜取出 5例 ,2例开腹取出 ,1例放弃。宫腔镜及腹腔镜手术取出异位环 ,诊断及治疗可同时进行 ,且对患者损伤小 ,术后恢复快 ,因此在绝大多数异位 IUD的诊治中将取代开腹取环术。但对异位于腹腔伴有严重粘连的 IU D,或者合并脏器损伤时 ,开腹取环并修补脏器损伤仍为必要。
An ectopic analysis of 13 cases of intrauterine contraceptive device (IUD) in our hospital from 1991 to 1998 found that the main reason for the suspicion of ectopic IU D was failure of fetus pregnancy (8/13). IUD ectopic diagnosis and positioning of the need to comprehensive application of abdominal B ultrasound, pelvic X-ray, hysteroscopy and laparoscopy and other inspection methods. Ectopic classification of 5 cases of incarcerated uterine muscle wall, including simple hysteroscopic surgery in 3 cases to remove the complete IU D, 1 case of some IUD rupture and leaving a little in the uterine wall, 1 case of the result of the fracture was taken out of the open Completely incarcerated in the muscle wall of the IUD; 8 cases of abdominal ectopic, laparoscopic removal of 5 cases, 2 cases of laparotomy, 1 case to give up. Hysteroscopy and laparoscopic removal of ectopic ring, diagnosis and treatment can be carried out at the same time, and small damage to the patient, postoperative recovery quickly, so the vast majority of diagnosis and treatment of ectopic IUD will replace open surgery. However, it is still necessary to open the ring and repair the organ injury when IU D is abnormally located in the abdominal cavity with severe adhesions, or when organ damage is combined.