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目的:探讨绝经后宫内节育器(IUD)取出困难的原因及宫腔镜在绝经后困难取IUD中的临床应用价值。方法:收集121例绝经后IUD困难取出妇女宫腔镜下取器的资料进行分析。结果:121例妇女在宫腔镜下均取器成功。术前应用超声诊断IUD嵌顿符合率为60%,灵敏度为62%,阳性似然比为1.24。另外,绝经≤1年组妇女IUD嵌顿数明显低于绝经1~2年及>2年组(P<0.05)。置器年限≤10年组IUD嵌顿数明显低于置器10~20年及>20年组(P<0.05)。结论:IUD嵌顿是绝经后取器困难的主要原因。宫腔镜能准确了解IUD宫腔内情况,很大程度上能提高取器成功率,降低手术风险,是一种安全、有效的取器方法。
Objective: To investigate the causes of the difficulties in removing the IUD after menopause and the clinical value of hysteroscopy in the treatment of IUD after the menopause. Methods: The data of 121 cases of hysteroscopic removal of women who had difficulty removing IUD after menopause were collected for analysis. Results: All 121 women were successful in hysteroscopy. Preoperative ultrasound diagnosis of IUD incarceration coincidence rate of 60%, the sensitivity was 62%, the positive likelihood ratio of 1.24. In addition, the number of IUD embeddings in postmenopausal women ≤ 1 year was significantly lower than those in menopause 1-2 years and> 2 years (P <0.05). IUD incarceration ≤ 10 years group was significantly lower than the implant 10 to 20 years and> 20 years group (P <0.05). Conclusion: IUD incarceration is the main reason for difficulties in postmenopausal devices. Hysteroscopy can accurately understand the intrauterine situation of IUD, to a large extent can improve the success rate of the device, reduce the risk of surgery, is a safe and effective method of taking the device.