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目的:宫内节育器(IUD)是一种安全、有效、简便、经济、长效的可逆性节育方法,是我国育龄妇女的主要避孕措施。但对于绝经后妇女因节育器放置时间相对较长、生殖器官的改变、生理功能的改变等,因此取出宫内节育器较困难。临床常见绝经后不提前进行宫颈等预处理,直接取环而失败的;或者方法欠合理,临床效果欠佳的。现探讨两种不同方法,即补佳乐与米非司酮(后者联用米索前列醇)在绝经后取环的临床疗效,从而优选一种最佳方法,以提高成功率。方法:绝经后(大于2年)需取环妇女100例随机分成两组,A组术前连续7天口服补佳乐(戊酸雌二醇片)3mg/天,服完后来院取环,B组给予米非司酮50mg每天早上7点空腹口服,连续3天,第3天来院取环,B组术前2h舌下含服米索前列醇200μg;按常规进行取环。比较A、B两组宫颈外观弹性,宫颈软化,术中不良反应,取环操作时间、一次性取环的成功率。结论:补佳乐可明显改善宫颈弹性条件,减少患者取环时的疼痛,缩短手术时间,提高取环的成功率。其各项指标优于米非司酮,更适合于绝经后妇女取环前的术前准备。
Objective: IUD is a safe, effective, simple, economical and long-term reversible method of birth control and is the main contraception for women of childbearing age in our country. But for postmenopausal women due to relatively long placement of the IUD, genital changes, changes in physiological functions, so removal of IUD more difficult. Clinical common postmenopausal cervical pretreatment is not advanced, the direct access to the ring and failed; or the method is not reasonable, the clinical effect of poor. Two different approaches, nootropic and mifepristone (the latter in combination with misoprostol), are now being explored to optimize the clinical outcome of postmenopausal procedures so as to optimize one of the best ways to increase success rates. Methods: 100 postmenopausal women (> 2 years old) were randomly divided into two groups. Group A received oral norepinephrine 3 mg daily for 7 consecutive days before operation, B group given mifepristone 50mg fasting orally at 7 o’clock in the morning every day for 3 days, the first 3 days to take hospital ring, B sublingual 2ml preoperative misoprostol 200μg; routine take ring. A, B two groups of cervical appearance elasticity, cervical softening, intraoperative adverse reactions, take the ring operation time, the success rate of one-time take the ring. Conclusion: Niajiale can significantly improve cervical elastic conditions, reduce pain when patients take the ring, shorten the operation time and improve the success rate of the ring. Its indicators are superior to mifepristone, more suitable for postmenopausal women preoperative preparation.