流产手术与宫内节育器放置致子宫穿孔临床分析.docVIP

流产手术与宫内节育器放置致子宫穿孔临床分析 　　【摘要】 目的：探讨流产手术和宫内节育器放置致子宫穿孔的原因、诊断和处理。方法：回顾2010年4月以来，在流产手术和宫内节育器放置时所导致的子宫穿孔患者41例，对其临床资料进行分析，查找引起穿孔的原因、诊断方法，总结有效处理措施。结果：引起穿孔的原因分为自身原因和医源性原因，自身原因是子宫位置不正、瘢痕子宫、子宫壁过薄，医源性原因是对危险因素评估不够、术前检查不清、术中操作不当刮取太过、器械深入太深、吸宫时负压太大。诊断为“无底感”，患者下腹突然牵拉痛、刺痛，有休克征象或发生休克，腹部有突然出现的炎性包块。36例经止血、抗感染、修补手术等保守治疗有效，5例子宫切除。结论：在流产手术或放置宫内节育器时，注意操作规范，避免子宫穿孔，如果发生穿孔，及时确诊治疗，减少子宫切除几率。 　　【关键词】 流产手术； 宫内节育器； 子宫穿孔 　　中图分类号 R711 文献标识码 B 文章编号 1674-6805（2014）10-0130-02 　　Clinical Analysis of Uterine Perforation Caused by Abortion Operation and Insertion of IUD/ZHOU Xiao-li，WANG Xian-mei.//Chinese and Foreign Medical Research，2014，12（10）：130-131 　　【Abstract】 Objective：To investigate the abortion operation and placement of intrauterine device causes，diagnosis and treatment of uterine perforation.Method：Since April 2010 review，resulting in induced abortion operation and IUD placement of uterine perforation in 41 cases，and the clinical data were analyzed to find the cause of perforation，cause，diagnosis method，summarizing the effective treatment measures.Result：The cause of perforation was caused by their own reasons and iatrogenic reasons，its reason was uterine malposition，scar uterus，uterine wall thin，iatrogenic reasons for risk assessment was not enough，the preoperative examination was not clear，the operation was improper scraping too，instruments into too deep，suction the palace was too big pressure.The diagnosis of “bottomless sense”，patients with infrarenal suddenly pulling pain，tingling，a shock signs or shock，the abdomen was sudden appearance of inflammatory mass.36 cases of hemostasis，anti infection，repair operation and conservative treatment were effective，5 cases of hysterectomy.Conclusion：The IUD in abortion operation，pay attention to the operation specification，avoid uterine perforation，if perforation occurs，timely diagnosis and treatment，reduce the risk of hysterectomy. 　　【Key words】 Abortion operation； Intrauterine device； Uterine perforation 　　First-author’s address：Zhongshan Ro