CAJ | 학술논문

目的：分析异位的宫内节育器（ IUD）损伤肠管的可能因素，探讨损伤肠管的异位IUD的处理方法。方法回顾性分析陕西省妇幼保健院6例异位IUD损伤肠管的病例资料。结果6例患者中1例为闭合式IUD，5例为非闭合式IUD；3例宫腔镜检查未见IUD，3例宫腔内可见1～10mm的部分IUD。6例患者均进行了腹腔镜取IUD术，4例腹腔镜成功取出，2例转开腹取出，6例患者均恢复良好。结论腹腔镜处理损伤肠管的异位IUD可作为首选治疗；宫腔镜仅见少部分异位的IUD时，不要盲目取出，先行腹腔镜探查并取出，必要时中转开腹取出。放置IUD后，必须定期随访以便及时发现异常并给予及时处理。
목적：분석이위적궁내절육기（ IUD）손상장관적가능인소，탐토손상장관적이위IUD적처리방법。방법회고성분석합서성부유보건원6례이위IUD손상장관적병례자료。결과6례환자중1례위폐합식IUD，5례위비폐합식IUD；3례궁강경검사미견IUD，3례궁강내가견1～10mm적부분IUD。6례환자균진행료복강경취IUD술，4례복강경성공취출，2례전개복취출，6례환자균회복량호。결론복강경처리손상장관적이위IUD가작위수선치료；궁강경부견소부분이위적IUD시，불요맹목취출，선행복강경탐사병취출，필요시중전개복취출。방치IUD후，필수정기수방이편급시발현이상병급여급시처리。
Objective To investigate the possible factors of intestinal damage by ectopic intrauterine device ( IUD) and to explore suitable ways to cope with it.Methods The clinical data of 6 cases with intestinal damage by ectopic IUD were studied retrospectively in Shaanxi Maternal and Child Health Hospital.Results Among 6 cases, one had closed-model IUD, and the other 5 cases had non-closed-model IUD.Hysteroscopy examination indicated nothing in 3 cases, while parts of IUD appeared varying from 1mm to 10mms in another 3 cases. All of the 6 patients recovered well after IUD was removed by laparoscopy in 4 cases or by open abdomen surgery in 2 cases.Conclusion Laparoscopic treatment can be taken as preferred treatment for ectopic IUD which leading intestinal injury.If only small part of IUD can be detected by hysteroscopy, it’ s wise to use laparoscopic examination firstly to identify its location and then remove it.If necessary, open abdomen surgery should be carried out.After putting IUD, regular follow-up should be taken so that abnormal situation could be found timely and treated in time.