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目的探讨戊酸雌二醇联合米索前列醇用于绝经后宫内节育器取出的临床疗效。方法将120名绝经后须取环妇女随机分为3组(每组40人):A组取环前1周开始服用戊酸雌二醇1mg,1次/d,术前2h米索前列醇200μg阴道穹窿上药;B组仅术前2h米索前列醇200μg阴道穹窿上药;C组术前1周服戊酸雌二醇1mg,1次/d。结果3组中A组和C组的阴道充血减轻,粘液增多,弹性改善均达100.0%,B组仅40.0%;宫颈软化效果A组92.5%最好,B组57.5%、C组42.5%;术中不良反应A组最轻87.5%,B组57.5%、C组37.5%;取环顺利A组90.0%,B组60.0%、C组40.0%。3组术中出血量差异无统计学意义。结论戊酸雌二醇联合米索前列醇联合用药更加安全,成功率较高,值得临床推广。
Objective To investigate the clinical efficacy of estradiol valerate combined with misoprostol for postmenopausal intrauterine device removal. Methods A total of 120 postmenopausal women were enrolled and divided into 3 groups (40 in each group): Group A received 1 mg estradiol valerate once daily for 1 week before taking the ring, and misoprostol 200μg of vaginal fornix on the drug; Group B only 2h preoperative misoprostol 200μg vaginal fornix on the medicine; Group C 1 week before the administration of estradiol valerate 1mg, 1 time / d. Results In group A and group C, the vaginal hyperemia, mucus increased, the elasticity improved 100.0% in group B and only 40.0% in group B; the cervical softening effect was the best in group A 92.5%, group B 57.5% and group C 42.5%; The adverse reaction in group A was the lightest with 87.5% in group A, 57.5% in group B and 37.5% in group C, 90.0% in group A, 60.0% in group B and 40.0% in group C, respectively. No significant difference was found between the three groups in the amount of bleeding. Conclusions Combination therapy of estradiol valerate and misoprostol is safer and the success rate is higher, which is worthy of clinical promotion.