B超联合药物用于剖宫产妇女绝经后取IUD困难的临床观察

Clinical observation on monitoring of B-ultrasound and Nilestriol complicating with Misoprostol for removal of IUD with difficulty in post-menopause women with caesarean delivery

目的探讨B超监测联合尼尔雌醇配伍米索前列醇用于剖宫产妇女绝经后宫内节育器(intrauterine contraceptive device,IUD)取出困难的临床观察。方法将2008～2011年来彭州市计划生育服务站的剖宫产绝经后取器困难的妇女146例分为A,B两组,每组各73例。所有患者于术前7天每日顿服尼尔雌醇4mg,A组手术当日术前2h置米索前列醇0.4mg于阴道后穹隆。观察两组患者手术时间,宫口大小及术中出血量。结果两组取器成功率差异无统计学意义(P>0.05);A组手术时间短于B组,宫口开大情况好于B组,术中出血量少于B组,其差异均有统计学意义(P<0.05)。结论对剖宫产绝经后取IUD困难的妇女,术前采用尼尔雌醇配伍米索前列醇软化及扩张宫颈,B超监测下取器成功率高,术中出血少,手术时间短,并发症少,是广大剖宫产妇女绝经后取器的一种好方法。

Objective To observe the effect on monitoring of B -ultrasound and Nilestriol complicating with Misoprostol for removal intrauterine contraceptive device （IUD） in post -menopause women with caesarean delivery. Methods 146 post - menopause women with caesarean delivery having difficulties in IUD removal in Pengzhou Family - planning Service Outlet from Jan 2008 to Dec 2011 were divided equally into group A and group B. All cases were administered everyday with 4 mg of Nilestriol at a draught from 7 - day ahead of the surgery. The cases in group A were placed with 0.4 mg of Misoprostol on their posterior vaginal fornix 2 hours before the surgery. The data of operation time,miyaguchi size and hemorrhage volume were compared between two groups. Results The success rate of IUD removal was insignificant （P 〉 0.05） between two groups. The operation time was shorter in group A than group B,while the cervix size and hemorrhage volume were also obviously better in group A than in group B with significant difference between them （P 〈 0. 05）. Conclusion Combination of Nilestriol with Misoprostol given before operation for IUD removal in post - menopause women with caesarean delivery is effective due to softening and expansion of their cervixes and resulted in higher success rate, shorter operation time,less hemorrhage volume and less complications.