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[“丢失”的宫内节育器(作者译)]

[The 'lost' intra-uterine contraceptive device (author's transl)].

作者信息

Tadjerouni A, Flici O, Wauters G, Hubinont P O

出版信息

J Gynecol Obstet Biol Reprod (Paris). 1981;10(5):473-8.

PMID:7033343
Abstract

The authors report five cases of lost intra-uterine devices, which means that the threads were not visible at the external os of the cervix. This gives them an opportunity to review the literature and to conclude the following: 1. Ultra-sound is the treatment of choice to find the position of the IUD that has been lost, whether is is intra- or extra-uterine. 2. In doubtful cases an antero-posterior and a lateral hysterogram makes it possible to determine the relative position of the IUD to the uterine cavity. Laparoscopy gives useful complementary information. 3. If the IUD is intra-uterine, either totally so or partially, the treatment of choice is to remove it under hysteroscopic control. 4. Where perforation has occurred and the IUD has only entered incompletely into the pelvis, it is possible to pull it out under hysteroscopic control through the vagina if laparoscopy has demonstrated that there are no local adhesions attaching it to neighbouring organs. 5. Where perforation has been complete, laparotomy is preferable to laparoscopy as a technique to recover the lost IUD, in particular when this is a copper one. 6. Perforations occur particularly when the IUDs are inserted post-partum.

摘要

作者报告了5例宫内节育器丢失的病例,即宫颈外口看不到尾丝。这使他们有机会回顾文献并得出以下结论:1. 超声是查找丢失的宫内节育器位置的首选方法,无论其位于宫内还是宫外。2. 在可疑病例中,前后位和侧位子宫造影有助于确定宫内节育器相对于子宫腔的位置。腹腔镜检查可提供有用的补充信息。3. 如果宫内节育器完全或部分位于宫内,首选的治疗方法是在宫腔镜控制下取出。4. 如果发生穿孔且宫内节育器仅不完全进入盆腔,若腹腔镜检查表明其未与邻近器官发生局部粘连,则可在宫腔镜控制下经阴道将其取出。5. 如果穿孔已完全形成,作为找回丢失的宫内节育器的技术,剖腹手术比腹腔镜检查更可取,尤其是当宫内节育器为铜质时。6. 穿孔尤其发生在产后插入宫内节育器时。

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