B超联合宫腔镜在取出困难的宫内节育器中的应用

据1994年第4次IUD国际会议数字统计，目前全世界有1．06亿育龄妇女使用宫内节育器，我国占8000万以上，达我国育龄妇女采用措施中的40％。据估计，我国目前有1亿多妇女使用IUD。同时，每年有数以万计的妇女因各种原因停用IUD，尤其是绝经后的妇女在取环过程中子宫穿孔等并发症时有发生。对要求取器的妇女及时完整取出IUD是确保女性生殖健康及计划生育实施的重要措施。目前宫腔镜已广泛应用于计划生育工作中。宫腔镜联合B超检查更好的观察IUD在宫腔内形态，嵌入的部位及范围，并可在直视下取出，避免病人的痛苦及减少并发症。现将本院经常规取器失败，后经宫腔镜诊断并取出情况作一分析。

Application of hysteroscopy and B ultrasound in removing IUD in difficult cases

Objective To evaluate the clinical value of removing IUD by hysteroscopy and ultrasound in diffiult cases. Methods After the failure of routine way, the IUD was identified first through B ultrasound only, then the IUD was identified again by the combination of hysteroscopy and B ultrasound. If the IUD was whole or part in the uterine cavity, the IUD was removed under direct visual of hysterescopy. Results In the all 34 eases, Ectopia IUDs were found in 24 cases. The results of ultrasonic examination were correct in 26 cases. The IUDs in 34 cases were successfully removed under the guide of hysterescopy and B ultrasound. Conclusion The main masons for failure cases were cervical stenosis and ectopia IUD. The combination of hysterocopy and B ultrasound can help us to define the precise location of the IUD and to choose a proper project to remove the IUD.