论文部分内容阅读
目的探讨宫腔镜在困难取环术中的临床应用价值。方法应用宫腔镜诊断宫内嵌顿环、断残环、异位环,并取出宫内嵌顿环、断残环和取环失败宫内节育器(IUD)。结果成功取出宫内嵌顿环、断残环、位置正常IUD(尾丝缺失)及异位环44例,其中在宫腔镜下成功地取出节育器38例(另有4例为异位环,游离至腹腔,腹腔镜取出),成功率95%(38/40),其中2例因T型节育器塑料托断片大部分植入肌层,经过试取失败后,经腹取环。成功取出38例中,IUD断片残留19例;部分嵌顿IUD12例;4例IUD扭曲变形;3例为V型节育器,尾丝缺失,位置正常。44例病历中25例为金属单环(2例异位腹腔),16例为T型环(2例异位腹腔),3例为V型节育器。同时发现宫腔病变7例,其中5例为子宫内膜息肉,2例为子宫黏膜下肌瘤,术后均经病理证实。结论带器者应按规定时间取器;术前做好充分的准备,包括绝经期软化宫颈的准备;手术操作者切不可盲取、强取;否则致宫内节育器金属丝断裂、断端嵌顿或将尾丝扯断,更不易取出。宫腔镜在困难取环中具有诊断明确、直观、安全、微创之优点,成功率高,有很高的临床应用价值。
Objective To investigate the clinical value of hysteroscopy in difficult circumcision. Methods Hysteroscopy was used to diagnose uterine incarcerated ring, broken ring and ectopic ring, and intrauterine incarcerated ring, broken ring and failed ring IUD were removed. Results The intrauterine incarcerated ring, the broken ring, the normal IUD and the ectopic ring were removed in 44 cases, of which 38 cases were successfully removed under hysteroscopy (another 4 cases were ectopic ring , Free to the abdominal cavity, laparoscopic removal), the success rate of 95% (38/40), of which 2 cases due to T-type plastic pedicel implant most of the muscular implants, after the trial failed, the ring to take the ring. Of the 38 cases successfully removed, 19 cases were left with IUD fragment, 12 cases were partially incarcerated with IUD, 4 cases were distorted by IUD, 3 cases were V-shaped IUD with missing tail filament and normal position. Of the 44 medical records, 25 were metal monocycles (2 ectopic), 16 were T-rings (2 ectopic abdominal) and 3 were V IUDs. At the same time, 7 cases of uterine lesions were found, of which 5 cases were endometrial polyps and 2 cases were uterine submucosal fibroids. The pathological findings were confirmed after operation. Conclusion with the device should be taken within the prescribed time; adequate preoperative preparation, including menopause to soften the preparation of the cervix; surgical operator must not blind access, forced to take; otherwise IUD wire rupture, broken end Incarcerated or tipped wire, more difficult to remove. Hysteroscopic ring in a difficult diagnosis with clear, intuitive, safe, minimally invasive advantages, high success rate, a high clinical value.