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目的研究雌三醇乳膏(欧维婷)联合米索前列醇应用于绝经后妇女宫内节育器(IUD)取出术中的临床效果。方法 2011年6月至2013年5月要求取出IUD的绝经后妇女240例,根据患者知情同意的原则分为观察组及对照组,每组120例。观察组欧维婷软膏0.5 g术前连续5 d每晚阴道内放置,手术当天术前4 h米索前列醇片0.6 mg阴道后穹窿放置后按操作常规行IUD取出术;对照组仅术前4 h阴道后穹窿放置米索前列醇片0.6 mg后取出IUD。观察两组患者宫颈软化程度、术中综合反应程度、IUD取出效果、取出时间及术中出血量。结果观察组患者宫颈软化程度、术中综合反应、取出顺利率均优于对照组(P均<0.05);IUD取出时间[(5.7±0.4)min vs(11.3±0.7)min]及术中出血量[(12.8±0.7)ml vs(24.5±0.2)ml]均低于对照组(P均<0.05)。结论欧维婷联合米索前列醇应用于绝经后妇女IUD取出术较术前单一运用米索前列醇,能进一步缩短手术时间,减轻患者痛苦,降低手术难度。
Objective To study the clinical effect of estriol cream combined with misoprostol in the treatment of postmenopausal women with intrauterine device (IUD) removal. Methods From June 2011 to May 2013, 240 postmenopausal women who requested IUD removal were divided into observation group (120 cases) and control group according to the principle of informed consent. Observed group Ovivting ointment 0.5 g preoperatively for 5 consecutive days every day intravaginally placed on the day of surgery 4 h preoperative misoprostol 0.6 mg vaginal posterior fornix after operation by routine IUD removal operation; control group only 4 h before surgery Vaginal posterior fornix placed 0.6 mg misoprostol tablets removed after IUD. The degree of cervical softening, the degree of intraoperative comprehensive response, the removal effect of IUD, the time of taking out and the amount of intraoperative bleeding were observed. Results The degree of cervical softening, intraoperative comprehensive response and successful rate of extraction in the observation group were better than those in the control group (all P <0.05). The duration of IUD removal was (5.7 ± 0.4) min vs (11.3 ± 0.7) min and intraoperative bleeding [(12.8 ± 0.7) ml vs (24.5 ± 0.2) ml] were lower than those in the control group (all P <0.05). Conclusion Oviving combined with misoprostol in postmenopausal women with IUD removal surgery using a single preoperative misoprostol, can further shorten the operation time, reduce patient pain and reduce the difficulty of surgery.