超声监测下应用米索前列醇联合利多卡因在绝经后妇女取器中的效果

Effect of application of misoprostol combined with lidocaine under ultrasonic monitoring on removing contraceptive device in postmenopausal women

目的探究超声监测下应用米索前列醇联合利多卡因在绝经后妇女取器中的效果。方法选择2017年1月至2018年1月我院收治的已绝育超过1年并要求取出宫内节育器(金属单环)的150例妇女作为研究对象,将2017年1月至2017年6月就诊的妇女设为参照组(75例),仅通过注射利多卡因实施常规操作取器;将2017年7月至2018年1月就诊的妇女设为研究组(75例),在超声监测下应用米索前列醇联合利多卡因取器。比较两组的宫颈软化扩张效果、取器过程中综合反应程度、取器效果、取器困难情况及手术情况。结果研究组的软化扩张率显著高于参照组,未软化扩张率显著低于参照组(P<0.05)。两组取器过程中综合反应程度无显著差异(P>0.05)。研究组的取器成功率显著高于参照组,取器失败率与困难率均显著低于参照组(P<0.05)。研究组的出血量显著少于参照组,手术时间显著短于参照组(P<0.05)。结论超声检测下应用米索前列醇联合利多卡因为绝经后妇女取出宫内节育器,可通过充分软化扩张宫颈实现成功取出节育器的目标,临床应用价值较高。

Objective To explore the effect of application of misoprostol combined with lidocaine under ultrasonic monitoring on removing contraceptive device in postmenopausal women. Methods From January 2017 to January 2018,150 women who had been sterilized for more than one year and asked to remove the intrauterine contraceptive device(metal single ring) admitted in our hospital were selected as the study objects. The women visited the hospital from January 2017 to June 2017 were set as reference group(75 cases), and given routine operation of removing contraceptive device only by injecting lidocaine;the women visited the hospital from July 2017 to January 2018 were set as study group(75 cases), and given misoprostol combined with lidocaine under ultrasonic monitoring to remove the contraceptive device. The effect of cervical softening and dilation, the comprehensive reaction degree in the process of removing the contraceptive device, the effect of removing the contraceptive device, the difficulty of removing the contraceptive device and the operation condition were compared between the two groups. Results The softening and dilation rate of the study group was significantly higher than that of the reference group, and the non softening and dilation rate was significantly lower than that of the reference group(P<0.05). There was no significant difference of the comprehensive reaction degree in the process of removing the contraceptive device between the two groups(P>0.05). The success rate of removing the contraceptive device in the study group was significantly higher than that in the reference group, and the failure rate and difficulty rate of removing the contraceptive device in the study group were significantly lower than those in the reference group(P<0.05). The amount of bleeding in the study group was significantly less than that in the reference group, and the operation time was significantly shorter than that in the reference group(P <0.05). Conclusion The misoprostol combined with lidocaine under ultrasonic monitoring applied in removing intrauterine contraceptive device in postmenopausal women can achieve the goal of successful removal of contraceptive device by softening and dilating the cervix, which has higher value in clinical application.