戊酸雌二醇、米非司酮配伍宫术宁胶棒用于生殖器萎缩妇女取环中的临床观察

Cinical Observation on Estradiol Valerate/Mifepristone Combined with Gongshuning Glue Stick in the IUD Taking from Edeatrophia Women

目的观察戊酸雌二醇、米非司酮配伍宫术宁胶棒用于生殖器萎缩妇女取环前的宫颈准备效果。方法将2010年6月至2012年10月宝鸡市人民医院妇科符合纳入标准的160例生殖器萎缩妇女根据用药不同分为两组,每组80例。A组:术前口服戊酸雌二醇片3 mg/d,连用7 d;B组:术前连续口服米非司酮片3 d,50 mg/d,取环时两组常规配伍宫术宁胶棒。对比A、B两组取环时的宫颈扩张难易度、术中疼痛反应、取环时间、取环成功率、取环前-后子宫内膜厚度,取环后阴道流血时间。结果 A组阴道分泌物多、疼痛评分低、扩张宫颈容易,A组取环成功率为93.8%(75/80),B组为92.5%(74/80),两组比较差异无统计学意义(P>0.05);A组取环前后子宫内膜厚度为(3.67±0.59)mm和(3.66±0.56)mm,B组取环前后子宫内膜厚度为(3.44±0.80)mm和(3.45±0.76)mm;A、B两组取环后阴道流血时间分别为(3.46±0.84)d和(3.45±0.82)d,两组比较差异均无统计学意义(P>0.05)。结论戊酸雌二醇、米非司酮两种药物用于生殖器萎缩妇女取环前的宫颈准备效果均切实、可靠。术前配伍宫术宁胶棒扩宫更安全。

Objective To observe the effect of estradiol valerate/mifepristone combined with gongshuning glue stick in taking IUD from the edeatrophia women. Methods A total of 160 edeatrophia women were divided into A/B two groups by the random draw method. Group A took estradiol valerate 3 mg/d in all 7 days. Group B took mifepristone 50 mg/d continuously for 3 days before surgery. Gongshuning glue stick were used in both groups before taking IUD. Cervical dilation difficulty degree, pain reaction, IUD taking time, IUD taking success rate,the thickness of the endometrium before and after IUD taking, and vaginal bleeding time after IUD taking were compared. Results Viginal secretions were more,pain scoring was lower,and cervical dilation was easier in group A than group B;the success rate of taking IUD in group A and B was 93.8% （75/80） and 92.5 % （74/80） respectively, no obvious difference between them （ P 〉 0.05 ）. The thickness of the endometrium before and after taking IUD of group A was （3.67 ±0.59） mm and （3.66 ±0.56） mm respectively, of group B was （ 3.44 ± 0.80 ）mm and （ 3.45 ± 0.76 ） mm respectively ; vaginal bleeding time after IUD taking of group A and B was （ 3.46 ± 0.84 ） d and （ 3.45 ± 0.82 ） d respectively, and the difference between the two groups was not statistically significant （ P 〉 0.05 ）. Conclusion Either estradiol valerate or mifepristone is effective in the cervical pretreatment of the edeatrophia women before taking IUD. Preoperative combination with gongshuning glue stick is safer.