放置不锈钢宫内节育器20年的子宫内膜亚显微结构的变化

为了了解放置不锈钢宫内节育器的安全性,我们收集了8例放置不锈钢宫内节育器20年、月经正常妇女之子宫内膜,在亚显微水平观察其变化。结果指出:压迫区子宫内膜有不同程度之萎缩或变性;移行区子宫内膜有轻度变性、轻度增生、个别细胞肥大及鳞状化生,未见明显癌变;远离区则无明显病变,对内源性性激素反应比较正常,即使核内管道系统与巨大线粒体亦仍在第17、19天两侧内膜中出现。因此,认为放置不锈钢宫内节育器20年后之子宫内膜不一定会发生严重的破坏或癌变。结合临床分析,将不锈钢宫内节育器存放时间延长至20年是可以的。

ENDOMETRIAL CHANGES OF UTERUS AFTER INSERTION OF STAINLESS STEEL RING FOR 20 YEARS-ULTRASTRUCTURAL CHANGES (PRELIMINARY REPORT)

The purpose of this study was to observe the safety of the prolonged use of the stainlesssteel ring. The endometria of 8 women who had had stainless steel ring insertion for 20years with normal menstruation were examined under the electron microscope. The resultswere: the pressed area of endometrium showed various degrees of atrophy or degeneration;the adjacent area showed slight degeneration or mild proliferation of the surface epithelium,few cells with hypertrophy or metaplasia; no apparent malignant changes had been found.The remote area did not show any apparent pathological changes. It seems their hormonalreactions were relatively normal, and even sensitive structures such as N.C.S. and giant mito-chondria still appeared. Thus, there seemed to be no severe endometrial destruction or ma-lignant chanes. In correlation with clinical analysis, it is suggested that the prolonged use of the stain-less steel ring for as long as 20 years seems to be safe.