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目的:评价米索前列醇应用在绝经期妇女宫内节育器取出的临床效果,并比较不同给药途径的疗效。方法:回顾性分析2012年1月～10月在我院接受宫内节育器取出术的30例绝经期妇女的临床资料,随机分成3组,即A组(不用药常规取环)、B组(口服给药组)、C组(阴道给药组),每组10例,观察比较各组宫颈软化、取器成功率及不良反应等指标。结果:B、C两组宫颈软化程度、疼痛程度及取器成功率明显优于A组,具有显著性差异(P<0.05),B、C两组以上指标无显著性差异(P>0.05),但是B组胃肠道反应明显,部分患者出现恶心、腹泻症状,A、C两组在术前后无明显不良反应。结论:术前阴道后弯窿放置米索前列醇具有方便、安全、镇痛效果明显、不良反应少等优点,疗效满意,值得在临床上推广使用。关键词:米索前列醇;绝经妇女;宫内节育器取出术;效果分析宫内节育器(IUD)是一种常用的长效避孕措施,许多妇女绝经后才取出IUD。绝经期女性由于雌激素水平降低,内外生殖器发生一系列的退行性改变,宫颈组织变硬萎缩,阴道缩窄,弹性纤维减少,子宫变小、萎缩,使IUD在子宫内嵌顿几率增加,术时难以钳夹牵引,引起宫颈扩张困难。作为一种新型口服前列腺素E1的衍生物,米索前列醇能增加宫颈胶原纤维分解,增强宫颈组织弹性,软化宫颈,促进子宫平滑肌收缩[1]。本文以2012年1月～10月在我院接受宫内节育器取出术的30例绝经期妇女为研究对象,评价米索前列醇应用在绝经期妇女宫内节育器取出的临床效果,并比较不同给药途径的疗效,发现术前阴道后弯窿放置米索前列醇临床疗效满意,现将有关资料整理报道如下。
OBJECTIVE: To evaluate the clinical efficacy of misoprostol in the removal of intrauterine devices in postmenopausal women and to compare the efficacy of different routes of administration. Methods: The clinical data of 30 cases of postmenopausal women who underwent IUD removal from January 2012 to October 2012 in our hospital were retrospectively analyzed. The patients were randomly divided into three groups: group A (no conventional withdrawal), group B (Oral administration group), C group (vaginal administration group), 10 cases in each group. The indexes of cervix softening, success rate of taking off and adverse reaction were observed and compared. Results: The degree of cervical softening, the degree of pain and the successful rate of the device in group B and C were significantly better than those in group A (P <0.05). There was no significant difference between the two groups (P> 0.05) , But gastrointestinal reaction was obvious in group B, some patients had nausea and diarrhea symptoms. There was no obvious adverse reactions in group A and C before and after operation. Conclusions: Misplaced misoprostol preoperative vaginal canal possesses the advantages of convenience, safety, obvious analgesic effect, less adverse reactions and satisfactory curative effect. It is worth to be popularized in clinic. Keywords: misoprostol; menopausal women; intrauterine device removal; effect analysis IUD is a commonly used long-term contraceptive measures, many women remove the IUD after menopause. Menopausal women due to lower estrogen levels, both inside and outside the genitals a series of degenerative changes, hardening of the cervix atrophy, narrowing of the vagina, reducing the elastic fibers, the uterus becomes smaller, atrophy, the IUD in the womb increased incarcerated, surgery Difficult to clamp traction, causing cervical dilatation difficulties. As a new oral prostaglandin E1 derivatives, misoprostol can increase cervical collagen fibers, enhance cervical tissue elasticity, soften the cervix, and promote uterine smooth muscle contraction [1]. In this paper, from January 2012 to October in our hospital received IUD removal of 30 cases of menopausal women as the research object, evaluation of misoprostol in the application of IUD in menopausal women out of the clinical effect, and compared The efficacy of different routes of administration found that preoperative vaginal catheterization misoprostol placed satisfactory clinical efficacy, the relevant information is now reported as follows.