米索前列醇用于有宫颈锥切术史女性早孕无痛可视人工流产术的临床观察  

Clinical observations on use of misoprostol tablets before visual painless induced abortion among early pregnant women with prior cervical conization

作　　者：张颖[1] 王疏影[1] 黎秀[1] 周军旗[1] 杨小燕[1] 陈桂清[1] 

机构地区：[1]武警四川省消防总队医院妇科,四川成都610072

出　　处：《四川医学》2013年第5期614-616,共3页Sichuan Medical Journal

摘　　要：目的探讨米索前列醇用于有宫颈锥切术史女性早孕无痛可视人工流产术前进行宫颈准备的临床价值。方法选择有宫颈锥切术史孕妇160例,分为A、B两组,每组80例,另选无宫颈锥切术史的孕妇80例归入C组。其中A组术前3h予以米索前列醇0.2mg阴道上药。三组均在静脉不插管麻醉和B超引导下按人流术常规进行手术。观察3组的宫颈松弛度、手术时间、术中出血量以及子宫损伤情况。结果 A组扩宫前宫颈自然松弛度好于B组和C组,相比有统计学意义(P<0.05);宫颈扩张效果A组明显好于B组。A组与C组在宫颈扩张效果、手术时间、术中出血、子宫损伤方面相比无统计学意义(P>0.05)。A组、C组与B组在宫颈扩张效果、手术时间、子宫损伤方面相比有统计学意义(P<0.05)。结论有宫颈锥切术史的孕妇接受无痛可视人流术时人流并发症的发生率高,应当把该类手术列入高危计划生育手术范围进行相应管理;术前用米索前列醇进行宫颈准备能起到降低人流并发症发生率的作用,可将此方法常规用于有宫颈锥切术史女性早孕无痛可视人工流产术。Objective To discuss the clinical value of using Misoprostol Tablets in cervical preparation before visual painless induced abortion among early pregnant women with prior cervical conization.Methods 160 pregnant women with prior cervical conization were divided into groups A and B,each of which consists of 80 cases;and 80 other pregnant women without prior cervical conization were designated as group C.Women in group A were given 0.2mg of misoprostol tablets via vaginal administration 3 hours before the abortion.All women in the three groups were operated under intravenous anesthesia without intubation（IVA） and induction by B-mode ultrasound according to the normal procedures of induced abortion.Then the cervical relaxation,operation time,amount of bleeding during operation,and the damage to the uterus were observed among women in the three groups.Results The natural cervical relaxation of women in group A before cervical dilatation was better than that of women in groups B and C,and the effect of cervical dilatation in group A was obviously better than that in group B.No significant difference（P0.05） in the effect of cervical dilatation,operation time,and damage to the uterus was found between groups A and C,but there was significant difference（P0.05） in the effect of cervical dilatation,operation time,and damage to the uterus between groups A and C and group B.Conclusion Visual painless induced abortion,due to the high incidence rate of its complications among pregnant women with prior cervical conization,shall be included in those highly risky birth control operations and managed accordingly;the use of Misoprostol Tablets for cervical preparation before the operation can lower the incidence rate of complications of induced abortion,and such approach can be popularized in visual painless induced abortion among early pregnant women with prior cervical conization.

关 键 词：宫颈锥切术史 无痛可视人流术 人流术并发症 米索前列醇 宫颈准备 

分 类 号：R169.42[医药卫生—公共卫生与预防医学]