绝经期妇女取环困难应对策略的对照研究

A Comparative Study of Menopausal Women's Coping Strategies for Difficulty in Taking Ring

目的:对取环困难的绝经期妇女给予相应的术前预处理方案,比较补佳乐(戊酸雌二醇片)和米非司酮加用米索前列醇在绝经后妇女取环术中的临床效果,并对各方案进行临床经验总结。方法:以2016年9月—2017年9月我院计划生育门诊就诊的180例绝经期要求取环的妇女作为研究对象,通过随机数据表法将其随机分为对照组与观察组各90例。对照组妇女取环前给予口服补佳乐2mg/d,连用7d;观察组第1天口服米非司酮50mg,第2天术前2h阴道后穹窿加用米索前列醇400ug。比较两组患者宫颈软化程度及取环结局两方面的差异,并对几例具有代表性取环困难的处理过程进行详细介绍。结果:两组患者宫颈软化情况比较,差异无统计学意义(P> 0. 05);两组取环成功率差异无统计学意义(P> 0. 05)。结论:两组药物均可明显软化宫颈,提高绝经期妇女取环的成功率,效果显著。不同的药物适用于不同的人群,选择合理、个性化的治疗方案,方可取得满意的临床效果。

Objective ：To give the preoperative pre -treatment regimens for menopausal women who have difficulty in taking rings. To compare the clinical effect of tonicol （estradiol valerate tablets） and mifepristone plus misoprostol in postmenopausal women undergoing ring removal,and to smnmarize the clinical experience for each protocol. Methods： From September 2016 to September 2017, 180 women undergoing menopause requiring treatment in our family planning clinic were randomly selected into the control group and the observation group by random data table method, and each of group with 90 eases. The women in the control group received oral supplement estradiol valerate 2mg/d for 7 days before taking the ring; the observation group received 50mg of mifepristone on the first day, and the second day before operation added 400mg of misoprostol. Comparing the two groups of patients with cervical softening and ringing outcomes were two differences. Several detailed descriptions of the process of the difficulty of representative ring taking were introduced in detail. Results ： There was no significant difference in cervical softening between the two groups （ P 〉 0.05 ）. There was no significant difference in the success rate of ring extraction between the two groups （P 〉 0.05）. Conclusions： Both groups of drugs can significantly soften the cervix and increase the success rate of taking out the ring in postmenopausal women. The effect is significant. Different drugs can be applied to different groups of people and a reasonable and personalized treatment plan can be selected to achieve satisfactory clinical results.