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[使用宫内节育器避孕的泌尿系统并发症]

[The urological complications of contraception using intrauterine coils].

作者信息

Derevianko I M, Derevianko T I, Ryzhkov V V

出版信息

Urol Nefrol (Mosk). 1997 Sep-Oct(5):27-30.

PMID:9412010
Abstract

Being a foreign body, intrauterine coil causes decubitus and inflammation of the adjacent tissues. Long-term carriage of the coil may give rise to endometritis, myometritis, parametritis, salpingo-oophoritis, tubo-ovarian inflammatory infiltrates. These infiltrates invade retroperitoneal pelvic fat and may obstruct pelvic ureters. Ureteral obstruction may bring about ureterohydronephrosis, pyelonephritis and renal calculi. The coil may be also responsible for chronic pyelonephritis. The authors have treated 64 females aged 18-45 years with urological complications due to intrauterine coils which stayed from 6 months to 14 years. 34 of them presented with attack of acute pyelonephritis, 29 with renal colic and acute pyelonephritis, 26 with renal calculi. To arrest renal colic and attack of acute pyelonephritis ureteral catheterization and renal pelvis drain were performed in 31 patients. One patient has undergone ureterolithotomy. 8 patients rejected removal of the coil and had recurrent renal colics and acute pyelonephritis attacks. Removal of the coil arrested pyelonephritis and lithogenesis in the kidney. In one case of coil removal there was injury to the uterine cervix and urinary bladder eventuating in vesicovaginal fistula.

摘要

宫内节育器作为一种异物,可引起褥疮及邻近组织炎症。长期放置节育器可能导致子宫内膜炎、子宫肌炎、宫旁组织炎、输卵管卵巢炎、输卵管卵巢炎性浸润。这些浸润可侵犯盆腔腹膜后脂肪,并可能阻塞盆腔输尿管。输尿管梗阻可能导致输尿管积水、肾盂肾炎和肾结石。节育器也可能是慢性肾盂肾炎的病因。作者对64名年龄在18至45岁之间、因宫内节育器导致泌尿系统并发症(放置时间为6个月至14年)的女性进行了治疗。其中34人出现急性肾盂肾炎发作,29人出现肾绞痛和急性肾盂肾炎,26人患有肾结石。为了缓解肾绞痛和急性肾盂肾炎发作,对31名患者进行了输尿管插管和肾盂引流。1名患者接受了输尿管切开取石术。8名患者拒绝取出节育器,反复出现肾绞痛和急性肾盂肾炎发作。取出节育器后,肾盂肾炎和肾结石的形成得到了控制。在1例取出节育器的病例中,宫颈和膀胱受到损伤,最终导致膀胱阴道瘘。

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