宫内节育器取出失败后再次手术的探讨

目的 比较宫内节育器手术取出失败后再次手术的3种手术方式.方法 2005年1～12月在我院门诊取环失败入院患者92例,其中取器失败1次61例,2次26例,3次5例.随机分为官腔镜下引导取环组(30例)、中弯钳盲取组(32例)、B超引导下取环组(30例).结果 宫腔镜下引导取环组1例环异位子宫浆膜层下,行腹腔镜下取出;中弯钳盲取组2例未完整取出后行宫腔镜取出,2例异位子宫浆膜层下行腹腔镜下取出;B超引导下取环组1例环异位子宫浆膜层,1例嵌顿子宫肌层,极小部分穿出子宫肌层行腹腔镜取出,余均顺利取出.3组手术时间、出血量和手术费用比较有显著性差异(P＜0.05),3组术后感染率、患者接受情况比较无显著性差异(P＞0.05).结论 宫腔镜下引导取环组安全性高,但费用高;中弯钳盲取组有风险,但较经济;B超引导组介于两者之间.临床可根据具体情况选择手术方式.

The approach of the three reoperation methods for patients failed with ring extraction

Objective To compare three reoperation methods for patients failed with ring extraction. Methods There were 92 hospitalized patients failed to remove IUD, in whom 61 patients failed once, 26 patients failed twice and five patients failed for three times. The 92 patients were randomly divided into three groups: in group one(n=30) the IUD was removed out by hysteroscopy; in group two(n=32), the IUD was extracted by medium curved forceps; in group three (n=30), the IUD was removed out by ultrasonic imaging. Re...