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目的:探讨舌下含服米索前列醇对围绝经期及绝经后取宫内节育器术前的宫颈扩张效果。方法:400例取宫内节育器而无禁忌症的围绝经期及绝经后妇女。随机分为观察组200例;对照组200例。两组在年龄、带环时间、绝经年限无统计学差异,具有可比性(P>0.05)。观察组术前3 h舌下含服米索前列醇400μg;对照组常规取宫内节育器。观察两组宫颈扩张程度、疼痛程度、取器结果及用药后副反应。结果:观察组宫颈软化扩张显效85.0%,有效14.5%,无效0.5%;疼痛0级为79.5%,Ⅰ级18.0%,Ⅱ级2.5%,Ⅲ级0.0%;取器顺利为92.5%,取器困难为7.5%,取器失败为0.0%,优于对照组(显效14.5%、有效56.0%,无效29.5%;0级12.0%,Ⅰ级21.0%、Ⅱ级57.5%、Ⅲ级9.5%;取器顺利17.0%,取器困难47.0%,取器失败36.0%),差异有统计学意义(P<0.05)。观察组的药物副反应9例(4.50%)。结论:围绝经期及绝经后取宫内节育器术前3 h舌下含服米索前列醇400μg能有效软化扩张宫颈,提高一次取器的成功率。
Objective: To investigate the effect of sublingual misoprostol on peri-menopausal and post-menopausal cervical intrauterine device preoperative cervical dilatation. Methods: 400 cases of perimenopausal and postmenopausal women without contraindications for IUD. Randomly divided into observation group of 200 cases; control group of 200 cases. There was no significant difference between the two groups in age, banding time and menopause (P> 0.05). In the observation group, 400 μg of misoprostol was subconjunctivally administered 3 h before operation; IUD was routinely administered in the control group. The degree of cervical dilation, the degree of pain, the results of the device and the side effects after treatment were observed. Results: In the observation group, the cervix softens and dilates markedly, the effective rate is 85.0%, the effective rate is 14.5% and the invalid rate is 0.5%; the pain level is 79.5%, the level Ⅰ is 18.0%, the level Ⅱ is 2.5% and the level Ⅲ is 0.0% Difficulty 7.5%, failure 0.0%, better than the control group (effective 14.5%, effective 56.0%, ineffective 29.5%; 0 12.0%, Ⅰ grade 21.0%, Ⅱ grade 57.5%, Ⅲ grade 9.5%; take 17.0% of patients successfully, 47.0% of patients got difficulties, and 36.0% failed to take the instruments). The difference was statistically significant (P <0.05). Observation group of drug side effects in 9 cases (4.50%). CONCLUSION: 400 μg of misoprostol administered subconjunctivally and intrauterine device 3 h after premenopausal menopause can effectively soften the dilated cervix and improve the success rate of one-shot retrieval.