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目的:探讨绝经后宫内节育器取出困难的原因以及处理办法。方法:回顾分析我院收治的300例绝经后宫内节育器取出困难患者的原因以及处理方法。结果:取器一次成功者295例(98.33%),5例由于有假道形成,于术后6个月内进行第二次宫腔镜取出术,成功取出宫内节育器。其中,108例宫内节育器位置正常,64例合并宫腔粘连,12例节育器断裂,41例节育器嵌顿,22例节育器残留,11例节育器变形,平均手术时间为21.32±5.43(min),平均术中出血量为16.14±3.18ml,术中未发生大出血、子宫穿孔等,术后无并发症发生。结论:绝经后,女性体内的雌激素水平下降,生殖器官萎缩,易导致取器困难。使用雌激素软化宫颈,合理辅助使用宫腔镜、B超等,可提高取器的成功率,值得临床广泛推广使用。
Objective: To investigate the causes of post-menopausal intrauterine device removal and its treatment. Methods: Retrospective analysis of 300 cases of patients admitted to our hospital for treatment of patients with difficult reasons for the removal of intrauterine devices and treatment methods. Results: 295 cases (98.33%) were successful in one time of operation, and 5 cases were removed by hysteroscope within 6 months after operation due to false passage. The IUD was successfully removed. Among them, 108 cases of IUD were normal, 64 cases with intrauterine adhesions, 12 cases of IUD break, 41 cases of IUD incarceration, 22 cases of IUD, 11 cases of IUD deformation, the average operation time was 21.32 ± 5.43 (min). The mean intraoperative blood loss was 16.14 ± 3.18ml. No major bleeding and uterine perforation occurred during operation. No postoperative complications occurred. Conclusion: After menopause, female estrogen levels decline, genital atrophy, easily lead to difficult to take the device. The use of estrogen to soften the cervix, a reasonable auxiliary use of hysteroscopy, B ultrasound, etc., can improve the success rate of the device, it is widely used in clinical promotion.