绝经后妇女宫内节育器3种取出方法比较  

Effect of three kinds of intrauterine device removal surgery applied in post-menopausal women

作　　者：刘洋[1] 丁小玲[1] 万启智 

机构地区：[1]成都市计划生育指导所,四川成都610031

出　　处：《西部医学》2015年第5期753-755,共3页Medical Journal of West China

摘　　要：目的探讨取出绝经后妇女宫内节育器的最佳有效方法。方法将229例要求取出宫内节育器的绝经后妇女随机分成3组,A组(76例):取器术前口服戊酸雌二醇1mg,每日3次,连服7天,术前2小时阴道后穹窿放置米索前列醇200μg,术前5分钟宫颈3、6、9、12点注射2%盐酸利多卡因5ml;B组(75例):米索前列醇及2%盐酸利多卡因联合应用,方法和剂量同A组;C组(78例):单用2%盐酸利多卡因,方法和剂量同A组。分析3种方法的临床效果。结果3种取器方法在宫颈软化、扩张程度、取器效果上差异有统计学意义(P<0.05)。A组宫颈软化效果最好,取器顺利者达84.2%,取器成功率100%,均优于另外2组。结论在绝经后妇女宫内节育器取出术前联合应用戊酸雌二醇、米索前列醇,配伍盐酸利多卡因能有效软化宫颈,对于绝经后妇女取器术前宫颈准备效果好,能显著增加取器的顺利度,提高成功率,减轻患者的痛苦。Objective To evaluate the curative effect of three methods used in the intrauterine device（IUD） re- moval surgery in post-menopausal women. Methods The selected 229 post-menopausal women requiring the IUD remov- al surgery were randomly divided into three groups. Group A （76 cases） orally took estradiol valerate 1 mg, three times a day for 7 days, placed misoprostol 200 μg in the vaginal fornix 2 hours before the surgery. And 2% lidocaine hydro- chloride was administrated through cervical local anesthesia 5 minutes before the surgery. Group B （75 cases） only used misoprostol combined lidocaine hydrochloride with the same dosage and administration in group A. Group C （78 cases） only used lidocaine hydrochlorlde, with the same dosage and administration in group A. The condition of cervical soften- ing and effect of removal for three groups were compared and analyzed. Results The cervical dilation and surgical success rate in group A were significantly different from that of the other two groups （P〈0.05）. Conclusion The method com- bined estradiol valerate, misoprostol and lidocaine hydrochloride before IUD removal surgery among post-menopausal women is helpful to expand the cervix and increase success rate of operation.

关 键 词：戊酸雌二醇 米索前列醇 盐酸利多卡因 绝经后妇女 宫内节育器 

分 类 号：R169.4[医药卫生—公共卫生与预防医学]