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目的探讨阴道后穹窿置米索前列醇用于人工流产术前宫颈软化扩张适宜的给药时间。方法采用前瞻性对比研究,将203例早孕妇女随机分为米索前列醇400μg术前2h置阴道后穹窿、米索前列醇400μg术前4h置阴道后穹窿、米索前列醇400μg术前4h置阴道后穹窿配伍1%利多卡因宫颈3点、9点各注射2m l以及不采用任何药物的A、B、C、D四组。观察并比较各组宫颈松弛程度、扩宫难易度、手术效果、疼痛程度、术前术后宫腔长度差、手术时出血量及人流综合征等参数。结果A、B、C组在术前宫颈松弛度和扩宫难易度方面差异无统计学意义(P>0.05)。而A、B、C组与D组比较差异具有统计学意义(P=0.000)。手术效果以及疼痛评分比较:A组与B组比较差异无统计学意义(P>0.05),A、B组与C组之间差异有统计学意义(P=0.008、0.007);A、B、C组与D组比较差异有统计学意义(P=0.000)。宫腔长度差及出血量在A、B、C、D组之间差异均无统计学意义(P>0.05)。A、B、C组均无人工流产综合征发生,D组1例发生人工流产综合征。结论人工流产术前阴道后穹窿置米索前列醇400μg可以有效地软化扩张宫颈,减少受术者痛苦;术前2h和4h用药同样可以有效地软化扩张宫颈;米索前列醇配伍利多卡因宫颈局部麻醉镇痛效果更佳。
Objective To investigate the appropriate dosing time of vaginal posterior fornix misoprostol for cervical dilation before artificial abortion. Methods A prospective comparative study of 203 pregnant women with early pregnancy was randomly divided into misoprostol 400μg 2h preoperative vaginal fornix, misoprostol 400μg 4h preoperative vaginal fornix, misoprostol 400g preoperative 4h Vaginal posterior fornix compatibility 1% lidocaine cervix 3:00, 9:00 injection of 2m l and do not use any drug A, B, C, D four groups. Observed and compared the degree of cervical relaxation, the difficulty of expanding the Palace, the effect of surgery, the degree of pain, preoperative and postoperative uterine cavity length difference, the amount of bleeding during surgery and flow syndrome and other parameters. Results There was no significant difference in the preoperative cervical relaxation and the ease of expansion between groups A, B and C (P> 0.05). The A, B, C group and the D group was statistically significant difference (P = 0.000). The difference between the two groups was statistically significant (P = 0.008,0.007); A, B, C group had no significant difference (P> 0.05) There was significant difference between group C and group D (P = 0.000). There was no significant difference in uterine cavity length and amount of bleeding between groups A, B, C and D (P> 0.05). No abortion syndrome occurred in groups A, B and C, and abortion syndrome in group D occurred in one case. CONCLUSIONS: 400 μg of misoprostol administered vaginally to the posterior vaginal fornix can effectively soften the cervix and reduce the pain of the surgeon. 2 h and 4 h before operation can soften and expand the cervix effectively. Misoprostol combined with lidocaine cervix Local anesthesia analgesic effect is better.