21例宫内节育器异位的临床分析

摘要

Objective To investigate the reasons and the methods for diagnosis, as well as prophylaxis and treatment, of ectopic IUD. Methods 21 cases records on ectopic IUD collected from January 2008 to May 2012 were analyzed retrospectively. Results The IUDs in 11(52.38%) women were partially embedded into the cervixes or myometriums, 4(19.05%) completely into the cervixes or myometriums, 1(4.76%) into cul-de-sac of Douglas, 2(9.52%) into vesicouterine pouch , 1(4.76%) into broad ligament and 2(9.52%) into enterocoelia. All the ectopic IUD cases operations under the X-ray or CT or the laparoscopy and hysteroscopy were successful. Conclusions Precise localization and proper diagnosis/remedy of ectopic IUDs require combination of various methods,such as CT, hysteroscopy et al. To strictly follow the IUD operation procedure with proper opportunity and proper types and to strengthen the after-IUD-insertion observation had great help to IUD ectopia prevention.%　　目的分析宫内节育器异位的成因、临床诊断、治疗和预防措施.方法对2008年1月-2012年5月进行的21例宫内节育器异位病例进行分析.结果11例(52.38%)部分异位于子宫颈或者子宫肌层,4例(19.05%)完全异位于子宫颈或者子宫肌层,1例(4.76%)异位于直肠子宫凹陷,2例(9.52%)异位于膀胱子宫凹陷,1例(4.76%)异位于阔韧带和2例(9.52%)异位于腹腔.所有病例借助X-射线、CT、腹腔镜或者宫腔镜成功取出.结论节育器异位的准确定位、诊断和治疗需要结合多种方法,如CT、宫腔镜等.选择适宜的时机和节育器类型,遵守严格的节育器操作规程以及加强置器后的随访有助于节育器异位的预防.