宫腔镜下诊断和处理宫内节育环82例分析

宫腔镜下诊断和处理宫内节育环82例分析 [?????e??]1002-0179(2008)02-0262-02 ???????)???????0?-??????????82???-?? DiagnosisandManagementon82CasesofIntrautericContraceptiveRingswithHysteroscopy ????,?????? 3 ,????,??????,???p CHENHui,LUOGuo-lin,CHENJie,etal. (?????E???????G???F????????,?????g??4?610041) (DepartmentofObstetricsandGynecology,WestChinaSecondUniversityHospital,SichuanUniversity,Chengdu610041,China) 4?4?????:????:?F?????N?3???????????.???????0?-??????????(IUD)????????????4]????:2004??9?9?? 2007??2?9?n?????????3????????????1327??,?????TIUD??????82??4]????24??70??,???<4617??;?????? ????????78????????B??????4]????????????????IUD?6??????4]?5??????42??4]???(?D?9????40??4]????: ????IUD??????,????O??IUD62??,???lIUD?????217??,IUD????13??,IUD???-????18??,IUD????11 ??,IUD????????????3??4]????????9??,???l????????????????6??,???-????3??4]?Y??????IUD6??4]?? ?l??????4??,???-????2??4]????????IUD3??4]IUD?P???????K??????2??4]????:???N?3???????????????0 ?-IUD?????????(????????4[?I?H?a4[?????E?????t??4] ???J??:??????;??????????;???o?p?? [?l???-????]R1691414?4?4?[???J?7???[]A Abstract:Objective:Tosummarythediagnosisandmanagementoncomplicationsofintrauterinedevice(IUD)withthe hysteroscopy.Methods:Eighty-twopatientaged24-70werediagnosedasIUDcomplicationsinthe1,327outpatientstotally withhysteroscopyinourhospitalfromSeptember2004toFebruary2007.Theaveragewas4617yearsold;78ofthemhadultra2 soundexaminationbeforehysteroscopy.DiagnosisandremovalofIUDwithhysteroscopyweresimultaneous.Forty-twocases wereusedlocalanesthesia,andtheother40caseswerebalancedanesthesia.Results:ThetypesofremovedIUD,H?62cases wereO-shapedmetalIUD,ofwhich,17withintegrity,13withfracture,18withresidue,11withincarcerated,3caseswith2 outintrauterineIUDandshiftingintotheintraperitoneal.H?9caseswereflowertypecontraceptiverings.6withintegrity,3with residue.H?6caseswereshield-shapedsiliconeIUD.4caseswithintegrity,2caseswithresidue.H?othert ypeswere3.H?2 accompanimenswereputintouterinebymistaking.Conclusion:Hysteroscopymayhelptoaccurateloca tion,lesstraumaand saferfordiagnosisandmanagementofcomplicationsofintrautericdevice. Keys:hysteroscopy;intrauterinecontraceptivedevice/IUD;ufamily-plan/familyplanning (Receiveddate:2007-11-05) 4????2????????(),??,???? ???6??,?F??????4] 4?4??n???????m?f,???o?p???.?n???? ???G????4]?K??IUD???????(????4[?? ??4[????4[????4[???????D?????E?p?F ???t??,???????.?n?????E?????????( ???????????F??????????4]?b?????? IUD?N?????8???N?T??,?e???K??4[?? ???????D??,?e??vr???pvu???????? IUD???????????p??4]2004??9?9?? 2007??2?9?n?????????3???????????? 1327??,?????TIUD??????82??,?? ?N???????)4] 14??:???P?? 1114?????:?G?????????????T24??70 ??,???<????4617??,?a??50??58?? (7017%),????50??60??20?? (2414%);?E??60??4??(419%)4] 1124??K??IUD????:?G???????K???? ?26?U?9,???2?T32??,???l?????T 12??4] 1134?????IUD?b?y??:?G??82???l?? 74??(9012%)?<?(??????IUD?b?y ??4]?????(??1?R????IUD?b?y?234 ????(4115%),???(2?R????IUD?b ?y?228??(3411%),3?R??3?R???8 ????IUD?b?y?212??(1416%)4] 1144??9??????:?U????60?? (7312%),??????22??(2618%)4] 1154???????????????:???????????? ????B??????78??,???T????IUD55 ??,????IUD????23??4] 4????? 2114??G?????????N???G???E???????? ????????????????,???e???????T6 mm,?????T30??4] 2124?????????????????:?5?(?????< ?????p?????y?E????,?U?????????N?9 ???????i3??7?L????4] 2134?????:?5??????42??,?b?????F ?p????,?????????H???-?O???0015% ?L?f????2mL4]???0???????4?????? ???:??4]???(????40??,?b?????9?? ??4] 2144???????:5%GS500mL???????E?( ?v8?7?????????????T?G?????????N?? ??????4]???????N???T300??1500mL ?D??,???<?N???T700mL4] 2154??3??????????????????IUD?6?? ???g78??4]?????U????IUD?23??, ?????N?????K??T??IUD?????i?????? ??4[????X???P?<,????IUD?i???? ????????4]?P?<?i????????T??IUD4] 34????? ???3?????????????TIUD?????? 82??,??????IUD??????????O??IUD ?T?F4]82???l??3??IUD?????????? ?2,?;?????????????)?????e,?????? ???<?N?????????????R????4] 3114?????O??IUD62??4]???l,???? IUD????17??;????IUD?????>?(?? ??11??;????IUD??????13??;???? ?????????u18??;?????U??IUD??X ???P?<????IUD??????????3??4]IUD ??????????3???l,?????i????,?? ???d???,????,??????????4]??3 ???<?;??????,?????????)???L????4] 3124???????9??,????????????????6 ??;????????3??4] 3134??Y??????IUD6??,????????4 ??;???-??????2??4] 3144?????????IUD3??4] 3154?IUD?P??2??,?b?????X?F???K ??IUD?????????????????-IUD???6?2 ?????????K??????,???A???????U???? ??4]?i???n???????3?????????????i, ????IUD?2???P??2??4] 44????? 4114?IUD?.???A????????????,???? ???A???p??????4[?????e???????????? ??????,?????????s?M?????????H4[?? ????????4[????????????4]???????2?? ????4]???N??????????,???D?????(?? ?????0?-?H?????????N,???????????? ??4]???????????????????????????? ??,?????)???????????????????????? ?)??,????????4[????????,?E?E???n ???D?????????????H4]?>???N???????( ????????,???????????????T?y?E???? ?p??,??4[??4[???????????y?E?p,?? ???w?????????v,???????????H?e?? ?I,?M?%???E???e?%?2?D?????N [1] 4]?? ?????)???????y?????????(????????4[ ???d?s??4[?:?l??4[???5??,?u???2?? ?????y?x?????]????4] 4124?????IUD???????????A??????, ????O??IUD?????????N?????T??, ???p?K?????s???p????,??????IUD?N ?????????????6???s????4[????,???? ?i??????IUD?????H?????????E,???? ?????T?f????4]?G??????O??IUD6?? 262WESTCHINAMEDICALJOURNAL2008,Vol123,No124?CN51-1356/R :1982- 2 1 11 2 18??(29%)IUD?U??????????, ?6???p?????-?????u????4]?K??4[???? IUD???????????????D?????????????? ?????-IUD???[??????4]?G???????l?( 3??IUD????????,???(2??IUD?P?? ?????K???????i?????D???(??4]IUD vr???p?D??vu???????N??????IUD?U?? ??????,?.?v?gIUD????4[????4[???? ??????????4]?G???????l?K??IUD???? 10???248??,??5815%4]?????i?U?? ??????,?????i?????????i?L????IUD ????,?v?g????IUD????4]?G???????l ???????2??(361%)?????E??5 ????(31%)4] 134??3???????????????0?-IUD???? ???????x,?3?????????????????????? ?????0?U????,??????????IUD?N???? ???.?,????,?e????,???????-?.?,?? ????????4]?T????IUD????????????, ?I?H?a,?????E??4]?????i?????????? ??????????IUD????4]?????n????4[?f ?R????IUD?????2?,?????D????????, ???????????????M???????????????y?? ??????4] ???8??,???N?3???????????????? ?0?-IUD?????????(????????4[?I?H ?a4[?????E?????t??4]???????)?????. ?A???????b?y?i?????U?(?????????? ??,?????????o?p???????E????,???? ?E???????n???D??????????,?x???:?? ???????N4] 54????1???J [1]??????,?1?k?u.???????0?-?A?????? ?b?y83??[J].???N?F???X??,2006, 23(4):431. [2]????.???????)???]?A??74???-?? [J].?l?????f?F???X??,2004,18 (4):224. [3]??????,?v??.???????N?????i?????? ???????l?????N[J].?l???????X??, 2000,6(6):39. [4]?????D,???L??.???????)?????????? ???????f[J].????????,2006,4 (12):20. [5]?t??,??????.???????)????18???-?? []???N?:???F??,6,(3)35 [6]????,?????i???????N?A???????b?y ?i?????N[]?l???:???F???i???-, 6,5 (?;?/???p5) [?????e??]1002-0179(2008)02-0263-02 ?????>??4[???1???????F???f???????X???9???????? ClinicalInvestigationontheEffectofLiveCombinedBacillusSubtilisandEnterococcusFaeciumGran ules ?????????E?????:?????? withMultivitaminesandPhenobarbitalSodiumintheTreatmentofBreast-milkJaundice ???A??,?????r CHENYong-xiu,CHENLi-na (?????E???????G???F???/??,?????g??4?610041) (PediatricalDepartment,WestChinaSecondUniversityHospital,SichuanUniversity,Chengdu61004 1,China) 4?4?????:????:?????????>??4[???1???????F???f???????X???9?????????????????E??????????4]????:?- 60???????E???????/???T?-?TR?4[R???,?030?????/4]?H???<???[????????,R????6???????????>??4[???1?? ?????F???f???????X??????????????;R??????N????????????4]?H?????/?<????7??14?L,???????????????? ??4[????????????7?L?i?5?2?????v?:?????e4]????:?D???i3?L?H?????/?????<????????,7?L??I??33%4[ R???20%?????/???????b;?G14?L??R???93%4[R???63%?????/???????b4]?N????,?H?????/?5?2?????v?:?? ???i?K???](P>0105),?N??7?L?iR????????v?:????R????i?K????(P<0105)4]????:???????E???????/,?? ?9???N?????>??4[???1???????F???f???????X??????????,???j?????????????5?2?????v?:???t?????N?????? ??,?????K??4] ???J??:?????>??4[???1???????F???f???????X;????????;?????E???? [?l???-????]R7221174?4?4?[???J?7???[]A Abstract:Objective:Toinvestigatetheeffectoflivecombinedbacillussubtilisandenterococcusfaeciumgranuleswithmul2 tivitaminesandphenobarbitalsodiuminthetreatmentofbreast-milkjaundice.Methods:Sixtyinfantsdiagnosedasbreast-milk jaundicewererandomlydividedintoGroupIandGroupR?,eachgrouphad30cases.Bothgroupscontinuedtobefedwithbreast milk.Meanwhile,GroupIwasgivenLiveCombinedBacillusSubtilisandEnterococcusFaeciumGranuleswithMultivitaminesand phenobarbitalsodiumsimultaneouslywhileGroupR?wassimplygivenphenobarbitalsodium.Bothgroupsweretreated7to14 days.ThechangesofpatientsvCjaundicewereobserved,serumbilirubinlevelsweremeasuredbeforeand7daysafterthetreat2 ment.Results:PatientsvCjaundicebegantoalleviate3daysaftertreatment.Thepercentageofpatientswhosejaundicedisappear was33%inGroupR?,22%inGroupR?7daysafterthetherapyand93%,63%respectivelyatthe14thdayoftreatment. Theserumbilirubinlevelsinbothgroupswerecomparablebeforethetreatment(P>0105),howeverthelevelwassignificantly lowerinGroupR?comparedwithGroupR?7daysafterthetherapy(P<0105).Conclusion:CombinationofLiveCombined BacillusSubtilisandEnterococcusFaeciumGranuleswithMultivitaminesandphenobarbitalsodiuminthetreatmentofbreast-milk jaundiceachievedbettereffectscomparedwithsingleusageofphenobarbitalsodium. Keywords:livecombinedbacillussubtilisandenterococcusfaeciumgranuleswithmultivitamines;phenobarbitalsodium; breast-milkjaundice (Receiveddate:2007-11-20) 4????2????:???A??(1949-),??,?? ?????S??,?F???F?94] 4?4????5????????????????,???/???? ?E?????????p???(?i?K?8?<????4]?N?D ?6???p4[?D?6?4?T,?????p?????]?? ?E,???n??????,?????E?????????p?? ???????????v??????????37%???8 [1] 4] ?????????????E?????f???N???N?????? ??5??7?L,???????????e?????i???? ??????4]??????????????,?>???-???? ?f????????????,???6?????/?,???D?? ?k???????b4]?T???X?(??????????, 2006??6?9??2007??3?9?n???????? 60???????????E?????????/?N???[?? ?????????????),?????????>??4[???1 ???????F???f???????X???9?????????? ???N????????????????????????,???? ?????)4] 14??????????? 362?????F??2008,23(2)4?CN51-1356/R 2280 2498 4 : J.2007:1. . J. 2001:4. :2007-11-0