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1、流产手术与宫内节育器放置致子宫穿孔临床研究【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
2、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)10-0130-02ClinicalAnalysisofUterinePerforationCausedbyAbortionOperationandInsertionofIUD/ZHOUXia.o-1i,WANGXian-mei.//ChineseandForeignMedicalRese
3、arch,2014,12(10):130-131[Abstract】Objective:Toinvestigatetheabortionoperationandplacementofintrauterinedevicecauses,diagnosisandtreatmentofuterineperforation.Method:SinceApril2010review,resultingininducedabortionoperationandIUDplacementofuterineperforationin41cases,andtheclinical
4、datawereanalyzedtofindthecauseofperforation,cause,diagnosismethod,summarizingtheeffectivetreatmentmeasures・ResuIt:Thecauseofperforationwascausedbytheirownreasonsandiatrogenicreasons,itsreasonwasuterinemalposition,scaruterus,uterinewallthin,iatrogenicreasonsforriskassessmentwasnot
5、enough,thepreoperativeexaminationwasnotclear,theoperationwasimproperscrapingtoo,instrumentsintotoodeep,suetionthepalacewastoobigpressure・Thediagnosisof“bottomlesssense”,patientswithinfrarenalsuddenlypullingpain,tingling,ashocksignsorshock,theabdomenwassuddenappearanceofinflammato
6、rymass.36casesofhemostasis,antiinfection,repairoperationandconservativetreatmentwereeffective,5casesofhysterectomy.Conclusion:TheIUDinabortionoperation,payattentiontotheoperationspecification,avoiduterineperforation,ifperforationoccurs,timelydiagnosisandtreatment,reducetheriskofh
7、ysterectomy.[Keywords]Abortionoperation;Intrauterinedevice;UterineperforationFirst-authorsaddress:ZhongshanRoadCommunityHealthServiceCenterinYongchuanDistrietofChongqingCity,Chongqing402160,China子宫属腔性脏器,在人工流产、清宫、放取环等腔内操作时,因操作不规范易引起子宫穿孔[1],如果发现和救治不及时,造成腹腔、盆腔器官严重失血、受损,可能引发进一步病菌感染,严
8、重者会危及患者生命。笔者回顾相关患者的临床资料,总结引起穿孔的原因,分析合理的处