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目的探讨米索前列醇在绝经后妇女宫内节育器(intrauterine contraceptive device,IUD)取出术中的应用价值。方法用随机对照研究的方法将90例需要取IUD的绝经后妇女按就诊顺序随机分为3组。A组30例,术前3小时将粉末状米索前列醇400μg置于阴道后穹窿;B组30例,术前8天给予尼尔雌醇4mg顿服;C组30例,取器前不用任何药物。观察宫颈软化及扩张情况、取IUD的不良反应和一次性取宫内节育器的成功率、并发症等。结果宫颈软化及一次性取IUD成功率情况:A组与B组比较有显著性差异(P<0.05);A组、B组与C组比较有显著性差异(P<0.05)。A组、B组都能取出IUD,难易程度各组存在差异;C组有2例取器失败。术中下腹疼痛情况:A组、B组比较差异无显著性(P>0.05);A组、B组与C组比较差异有显著性(P<0.05)。结论术前使用尼尔雌醇口服或米索前列醇阴道后穹窿放置均为安全、方便、有效的软化宫颈的方法 ,米索前列醇阴道后穹窿放置宫颈软化作用更好。
Objective To investigate the value of misoprostol in the removal of intrauterine contraceptive device (IUD) in postmenopausal women. Methods Ninety postmenopausal women who needed IUD were randomly divided into three groups according to the order of their visits with a randomized controlled study. A group of 30 patients, 3 hours before surgery will be placed in powdery misoprostol 400ug vaginal fornix; B group of 30 patients, 8 days before surgery to give nylestriol 4mg Dayton clothing; C group of 30 patients, Any medicine. Observation of cervical softening and expansion, take IUD adverse reactions and one-time take IUD success rate, complications and so on. Results Cervical softening and one-time success rate of taking IUD: A group and B group were significantly different (P <0.05); A group, B group and C group was significantly different (P <0.05). A group, B group can remove the IUD, the difficulty of each group differences; C group 2 cases failed to pick up. Abdominal pain during surgery: A group, B group was no significant difference (P> 0.05); A group, B group and C group was significantly different (P <0.05). Conclusion Preoperative use of nilestriol oral or misoprostol vaginal posterior fornix are safe, convenient and effective method of softening the cervix, misoprostol vaginal posterior fornix placed cervical softening better.