三种药物疗法在绝经后妇女节育环取环术中的比较

Compare of removal of intrauterine device in postmenopausal women by three kinds of drugs

目的探讨三种药物疗法在绝经后妇女节育环取环术中的临床效果。方法将120例妇女B超测出子宫三条径线之和<10 cm(不包括宫颈)的患者,随机分为四组,每组30例。A组服用米非司酮25 mg,Bid,连续3 d,第4天取环前2 h舌下含化米索前列醇200μg;B组口服补佳乐1mg,每天1次,共10 d后取环;C组阴道塞用己烯雌酚0.25 mg,每天1次,共10 d后取环;对照组不作处理,检查后直接取环。比较四组取环时情况及手术成功率。结果甲组宫颈扩张情况、手术时间、术中出血量、手术成功率、术中镇痛及术后腹痛持续时间与其他3组相比,差异显著(P<0.05)。而乙组与丙组相比,均无明显差异(P>0.05);但与对照组相比,宫颈扩张情况、手术成功率及术中镇痛有显著差异(P<0.05),而手术时间、术中出血量、术后腹痛持续时间无明显差异(P>0.05)。结论绝经后B超提示子宫萎缩的妇女,术前应用米非司酮配合米索前列醇,取环中成功率高,痛苦小,方法简便,值得临床推广。

Objective To investigate the clinical effect of three rinds of drugs. Methods A total of 120 women removal of intrauterine device in postmenopausal women by thought B-ultrasonics measuring the sum of three uterine lines less-than 10 cm（ex uterine neck） were randomly divided into four groups, each group was 30 cases. A group were used mifepristone at dose of 25 mg every time twice daily for 3 d in the three days before operation,done the removal of in- trauterine device on the forth day, and used misoprostol at dose of 200 txg in the two hours before the removal of in- trauterine device by sublingual administration. B group were used estradiol valerate 1 rag, po, qd,lO d. C group were used stilboestrol 0.25 mg, qd, 10 d by vaginal plug. The control group were not treated. The situation of removal of in- trauterine and surgery success rates of four groups were compared. Results A group were best in intenerating cervix, success operative rate, operative analgesia, operative time, amount of bleeding in surgery and duration of postoperative abdominal pain among four groups. Conclusion Combination of mifepristone and misoprostol before the removal of in- trauterine device for the women by postmenopausal B-ultrasonics show uterine atrophy has high success operation rate, less pain and simple preparation. It is worthy for clinical popularization.