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目的分析影响宫内节育器(IUD)取出困难的相关因素,探讨合理的置器取器时机及方法。方法将在我院取器的2012例妇女的临床资料进行回顾性分析,分为取器容易组和取器困难组。将取器年龄、放置年限、孕产次、剖宫产史、放器时机、取器时机、子宫位置、IUD类型等进行对比分析。结果取器困难组放置年限及年龄高于取器容易组(P<0.01)。绝经期妇女取器困难的比率较高,有剖宫产史者取器困难高于无剖宫产史者。人工流产同时和哺乳期闭经时放置IUD取器困难的比率高于正常月经后(P<0.01)。主要原因为IUD嵌顿,其次为取器器械进入宫腔困难。有尾丝的混合IUD,取器困难主要原因为超年限放置,部分断裂或金属附件丢失。结论选择合适的置器取器时机,选择适当的IUD类型,规范的操作,定期合理检查,加强告知宣传工作能有效的降低取器困难的发生率。
Objective To analyze the related factors that affect the removal of intrauterine devices (IUDs), and to explore the reasonable timing and method of instrument placement. Methods A retrospective analysis was performed on the clinical data of 2012 women in our hospital, divided into easy-to-take group and difficult-to-take group. Age, place of life, pregnancy time, history of cesarean section, timing of device, timing of device, position of uterus, type of IUD were comparatively analyzed. Results Difficult to take the device group placement life and age higher than the easy device group (P <0.01). Menopausal women with a higher rate of difficult devices, those who have a history of cesarean delivery difficulties higher than those without cesarean section history. The ratio of difficulty in placement of IUD during amenorrhoeic abortion at the same time and during lactation was higher than that after normal menstruation (P <0.01). The main reason is IUD incarceration, followed by access to uterine cavity device difficult. The mixed end IUD with a tail wire, the main reason for difficult to take the device for years of placement, partial fracture or loss of metal attachments. Conclusion Choosing the appropriate timing of device acquisition, selecting the appropriate type of IUD, standardizing the operation, and regularly and reasonably checking, to inform the publicity work can effectively reduce the incidence of difficult to get rid of.