经阴道三维超声诊断内节育器嵌顿.docVIP

经阴道三维超声诊断宫内节育器嵌顿 　　[摘要] 目的 探讨经阴道三维超声检查在诊断宫内节育器（IUD）嵌顿中的价值。 方法 对30例在二维超声检查中怀疑有宫内节育器（IUD）嵌顿的患者行阴道三维超声检查，通过三维超声图像来分析子宫腔、子宫肌层与IUD的关系，从而明确IUD的位置，最后再将阴道三维超声的诊断结果与宫腔镜、腹腔镜手术后的结果进行对比。 结果 30例患者均获取了较满意的三维超声声像图，可清晰显示出IUD的形状、位置及其与子宫腔、子宫肌层的关系。行宫腔镜、腹腔镜手术29例，1例患者评估后在超声监护下经阴道行取环术，术中所见均与三维超声诊断结果相一致。 结论 经阴道三维超声检查在诊断宫内节育器嵌顿中具有很高的价值。 中国论文网 /6/viewhtm　　[关键词] 超声检查；三维成像；宫内节育器嵌顿 　　[中图分类号] R445.1 [文献标识码] B [文章编号] 1673-9701（2017）35-0125-04 　　[Abstract] Objective To investigate the value of transvaginal three-dimensional ultrasonography in the diagnosis of the incarceration of intrauterine device （IUD）. Methods 30 patients suspected of the incarceration of intrauterine device in two-dimensional ultrasound examination underwent transvaginal three-dimensional ultrasonography. The relationship between uterine cavity and myometrium， IUD was analyzed by three-dimensional ultrasonography to clarify the position of IUD， and finally the diagnosis results of three-dimensional ultrasound and the results of hysteroscopy and laparoscopic surgery were compared. Results 30 patients all underwent a satisfactory three-dimensional ultrasonography. The shape and location of IUD and its relationship with uterine cavity and myometrium were clearly showed. 29 patients underwent hysteroscopy， laparoscopic surgery， and 1 patient underwent the removal of transvaginal IUD under ultrasonography after evaluation. All intraoperative findings were consistent with the diagnosis results of three-dimensional ultrasonography. Conclusion Transvaginal three-dimensional ultrasonography has a high value in the diagnosis of the incarceration of intrauterine device. 　　[Key words] Ultrasonography； Three-dimensional imaging； Incarceration of intrauterine device 　　?m内节育器（intrauterine contraceptive device，IUD） 是我国育龄妇女最常用的节育用具之一，是通过化学物质的干扰和机械性的刺激从而达到避孕的目的，主要作用于局部，对全身影响较少，并且取出后不会影响生育，具有安全、有效、经济、简便等优点[1]。IUD在宫腔内位置会直接影响其避孕效果。IUD因会受放置时间及宫腔压力的影响，会发生形状变化、位置变化、断裂、嵌入子宫肌层等现象，从而导致避孕失败甚至出现一系列的并发症，如：腹痛、阴道出血、妇科炎症等，如果发生节育器嵌顿可能会导致进一步的取环手术出现