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Interventional Treatment of Intrauterine Foreign Body <?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />
张 丹
首都医科大学附属复兴医院超声影像科，北京 100038
Zhang Dan
Dept. of Ultrasound, Affiliated Fuxing Hospital of Capital University of Medical Sciences, Beijing 100038,China
Abstract
Purpose：To study the value of interventional treatment transabdominal for resecting of intrauterine foreign body in using ultrasound.
Material and Methods：From Oct. 1994 to Aug. 2004, an interventional treatment was performed in 53 patients with remained intrauterine device，embryo and placenta after the general uterine curettage and removal intrauterine device was failed by ultrasonography and hysteroscope. Before operation, all patients underwent interventional ultrasounic examination for conforming the position and the size of the foreign body. The whole operation procedure was monitored by transabdominal ultrasound but one with laparoscopic ultrasound.
Results：The incarcerated intrauterine device in 29 patients were removed with operating hysteroscope under the ultrasonographic monitoring., 3 of which have intrauterine synechia. By the same method, the residual fetal bone and placenta in 24 patients were resected , 8 of which have adherent placenta , and placenta implantation in 2 patients. 1 out of 53 patients was perforated.
Conclusion：The transabodominal ultrasound guidance is noninvasive and may decrease the uterine perforation, which is the first method to monitor the trascervical resection of foreign body.
Key words：intrauterine foreign body; ultrasound; hysteroscope; interventional treatment
子宫腔内异物主要为滞留宫腔内的胎盘或胚胎、残留宫腔或嵌顿宫壁的节育器。由于子宫腔空间狭小，以及异物与子宫壁粘连、植入或嵌入，致临床操作困难。本研究采用超声介入宫腔镜手术的方法，为临床治疗提供一种超声影像介入的手段。
材料和方法
一、材料
1994年10月～2004年8月在我院确诊有子宫腔内异物的患者53例，平均年龄41岁（24～62岁）。
节育器部分嵌入子宫壁内29例，其中完整环7例，环断裂3例，残环15例，输卵管节育器4例（单侧3例，双侧1例）。15例残环患者中伴腹痛7例，阴道出血1例，无症状者2例。
胎骨残留宫腔8例，其中5例为人工流产术后继发不孕就诊，3例为超声检查发现发现胎骨残留宫腔。8例中有4例胎骨嵌入子宫肌壁内，3例合并宫腔粘连。
胎盘残留宫腔16例，13例合并阴道出血，2例继发不孕，1例清宫后4个月无月经。胎盘残留时间为人流术后40天～3年。
本组全部病例均在外院行常规清宫术或取环术失败，转我院行超声介入宫腔镜手术，并经手术和病理证实。 | 
