绝经后妇女取环前两种软化宫颈方法的比较

Comparison between two methods of softening cervix before taking out IUD for postmenopausal women

目的探讨绝经后妇女取环前使用尼尔雌醇和米索前列醇对软化宫颈及手术效果的影响。方法对绝经后168例取环者随机分成三组,A组62例取环前一周口服尼尔雌醇片,B组51例术前阴道放置米索前列醇片,C组55例,采取传统方法直接取环。比较三组取环时宫颈软化松弛程度、手术难易程度和成功率。结果宫颈软化效果A组最好,B组次之,A、B两组间差异具有统计学意义(P<0.05),手术难易程度A、B两组间差异具有统计学意义(P<0.01),手术成功率两组间无统计学意义(P>0.05)。C组与前两组比较,宫颈软化程度、手术难易程度和手术成功率差异均有显著统计学意义(P<0.01),手术难度大,失败率高。结论绝经后妇女取环前口服尼尔雌醇片,或术前阴道放置米索前列醇片,可达到软化宫颈的效果,明显增加取环成功率。

Objective To investigate the effect of using the nilestriol and misoprostol before taking out IUD on softening cervix and operation effect for postmenopausal women. Methods 168 postmenopausal women needing to take out IUD were randomly divided into the three groups,62 cases of the group A took nilestriol tablets orally at a week before taking out IUD,51 patients of the group B were treated with preoperative vaginal misoprostol tablets,55 cases of the group C were used traditional method to take out IUD directly. The degree of cervical softening and relaxation,ease of operation and success rate during the taking out IUD were compared among the three groups. Results The effect of cervical softening in the group A was best,followed by the group B,the difference was significant between the group A and B（P0.05）. The differences were significant in the degree of cervical softening,ease of operation and success rate of operation between the group C and A or B（P〈0.01）,the group C had a very messy operation and high failure rate. Conclusion Taking nilestriol tablets orally and giving vaginal misoprostol tablets before taking out IUD for postmenopausal women can reach the effect of cervical softening,significantly increase the successful rate of taking out IUD.