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目的观察绝经后妇女应用雌激素配伍米索前列醇安全取出宫内节育器(IUD)的有效方法。方法将医院2010年1月-2013年1月3年中妇科门诊绝经后要求取环的70例妇女随机分为观察组和对照组各35例,观察组无用药禁忌证,取环前给予雌激素(戊酸雌二醇1mg或结合雌激素片0.625mg)、每天1次、连服7d,取环前2h于阴道后穹窿置于米索前列醇400μg。对照组常规取环。观察2组患者的宫颈软化程度,术中全身不良反应,术中疼痛,取环成功率。结果观察组用药后宫颈松弛软化的有效率达94.29%明显高于对照组的68.57%(P<0.05);观察组取环时的疼痛程度重度、中度疼痛率低于对照组,轻度高于对照组(P<0.05);观察组取环成功率大幅高于对照组(P<0.05);观察组无不良反应31例(88.57%),对照组无全身不良反应21例(60.00%)(P<0.05);观察组取环顺利程度高,手术时间短;对照组取环顺利程度低,手术时间长。2组比较差异均有统计学意义(P<0.05)。结论雌激素配伍米索前列醇用于绝经后取环可明显改善宫颈条件,减轻患者的痛苦,提高绝经后妇女取环成功率,值得临床推广使用。
Objective To observe the effective method of safely removing IUD with estrogen and misoprostol in postmenopausal women. Methods Seventy women who were asked to take the ring after the menopause from March 2010 to January 2013 in the hospital from January 2010 to January 2013 were randomly divided into observation group and control group with 35 cases each. The observation group received no drug contraindication, Hormone (estradiol valerate 1mg or conjugated estrogen tablets 0.625mg) once daily for 7d, take 2h before the ring in the vaginal posterior fornix 400kg misoprostol. Control group conventional ring. The degree of cervix softening, intraoperative systemic adverse reactions, intraoperative pain, and the success rate of ring extraction were observed in two groups. Results The effective rate of cervical relaxation and softening in the observation group was 94.29%, which was significantly higher than that in the control group (68.57%, P <0.05). The degree of pain in the observation group was severe, the rate of moderate pain was lower than that of the control group, (P <0.05). There were 31 patients (88.57%) in the observation group and 21 patients (60.00%) in the control group without systemic adverse reactions (P <0.05). The observation group received a high degree of smooth operation and a short operation time. The control group received a low degree of smooth operation and a long operation time. The differences between the two groups were statistically significant (P <0.05). Conclusion Estrogen with misoprostol for postmenopausal ring can significantly improve the cervical conditions, reduce patient pain and improve the success rate of postmenopausal women taking ring, it is worth promoting the use of the clinic.