James Phillip, Trenery John
The Northern Hospital, Epping, Victoria, Australia.
Aust N Z J Obstet Gynaecol. 2006 Jun;46(3):225-8. doi: 10.1111/j.1479-828X.2006.00576.x.
Implanon is the trade name for a contraceptive implant that releases etonogestrel over a 3-year period. The rod is inserted into the subdermis of the upper arm. The implant should be palpable and easily removed through a small incision.
To determine whether ultrasound is an accurate means of localising and guiding removal of non-palpable Implanon implants.
All patients referred to The Northern Hospital, between March 2002 and October 2005, for localisation and/or removal of their non-palpable Implanon implants were included in this study. Ultrasound was used to locate the implants, the implant was considered localised when a linear echogenic rod with posterior acoustic shadowing was identified. When removal of the implant was requested and the implant was clear of neurovascular structures, blunt dissection was performed under ultrasound control and the implant was extracted. If the implant was considered too close to major neurovascular structures, the position of the implant was marked and the patient was referred for surgical removal.
Thirty-four women were included in the study. In 33 patients the implant was identified. In one patient no implant was found and its absence was confirmed by serum assay. Twenty-four patients were referred for implant removal. In 20 patients the implant was successfully removed under ultrasound guidance. In the other four patients the implant was close to neurovascular structures. The position of the implants was marked and surgical removal was successfully performed.
Ultrasound is highly accurate at localising and guiding removal of non-palpable Implanon implants.
依伴侬是一种避孕植入剂的商品名，它能在3年内持续释放依托孕烯。该棒状植入剂被插入上臂的皮下组织。植入剂应可触及，且能通过一个小切口轻松取出。
确定超声是否是定位和引导取出无法触及的依伴侬植入剂的准确方法。
本研究纳入了2002年3月至2005年10月期间转诊至北部医院进行无法触及的依伴侬植入剂定位和/或取出的所有患者。使用超声定位植入剂，当识别出带有后方声影的线性强回声棒时，即认为植入剂已定位。当要求取出植入剂且植入剂远离神经血管结构时，在超声引导下进行钝性分离并取出植入剂。如果认为植入剂过于靠近主要神经血管结构，则标记植入剂的位置，并将患者转诊进行手术取出。
34名女性纳入本研究。33例患者的植入剂被识别。1例患者未发现植入剂，血清检测证实其不存在。24例患者被转诊取出植入剂。20例患者在超声引导下成功取出植入剂。另外4例患者的植入剂靠近神经血管结构。标记了植入剂的位置，并成功进行了手术取出。
超声在定位和引导取出无法触及的依伴侬植入剂方面具有高度准确性。
