米索前列醇不同给药途径对宫腔镜术前宫颈软化的效果比较

The effect comparison of different routes of administration of misoprostol on cervical softening before hysteroscopy

目的 比较米索前列醇不同给药途径对宫腔镜术前宫颈软化的临床效果。方法 76例择期行宫腔镜手术患者,根据随机数字表法分为口服给药组和阴道给药组,每组38例。口服给药组给予米索前列醇口服给药治疗,阴道给药组给予米索前列醇阴道给药治疗。比较两组患者宫颈软化效果及扩宫疼痛程度、用药不良反应发生情况。结果 阴道给药组患者宫颈软化显效31例(81.58%)、有效5例(13.16%)、无效2例(5.26%),总有效率为94.74%;口服给药组患者宫颈软化显效22例(57.89%)、有效8例(21.05%)、无效8例(21.05%),总有效率为78.95%。阴道给药组患者宫颈软化总有效率高于口服给药组,差异有统计学意义(P<0.05)。阴道给药组患者扩宫疼痛程度Ⅰ级30例(78.95%)、Ⅱ级5例(13.16%)、Ⅲ级2例(5.26%)、Ⅳ级1例(2.63%);口服给药组患者扩宫疼痛程度Ⅰ级20例(52.63%)、Ⅱ级8例(21.05%)、Ⅲ级6例(15.79%)、Ⅳ级4例(10.53%)。阴道给药组患者扩宫疼痛程度低于口服给药组,差异有统计学意义(P<0.05)。阴道给药组患者发生腹泻2例(5.26%)、腹痛3例(7.89%)、恶心呕吐1例(2.63%)、头痛头晕1例(2.63%),不良反应发生率为18.42%;口服给药组患者发生腹泻4例(10.53%)、腹痛5例(13.16%)、恶心呕吐6例(15.79%)、头痛头晕2例(5.26%),不良反应发生率为44.74%。阴道给药组患者药物不良反应发生率低于口服给药组,差异有统计学意义(P<0.05)。结论 宫腔镜术前予以米索前列醇阴道给药可明显提高患者的宫颈软化效果,减轻扩宫疼痛程度,还可明显降低药物不良反应发生率,值得临床推广应用。

Objective To compare the clinical effect of different routes of administration of misoprostol on cervical softening before hysteroscopy. Methods A total of 76 patients undergoing elective hysteroscopic surgery were divided into oral administration group and vaginal administration group according to the random numerical table, with 38 cases in each group. The oral administration group was treated with oral administration of misoprostol, and the vaginal administration group was treated with vaginal administration of misoprostol. The cervical softening effect, the pain degree of uterine dialation and the occurrence of adverse drug reactions were compared between the two groups. Results In the vaginal administration group, 31 cases(81.58%) of cervical softening were markedly effective, 5 cases(13.16%) were effective, and 2 cases(5.26%) were ineffective, with a total effective rate of 94.74%;in the oral administration group, 22 cases(57.89%) of cervical softening were markedly effective, 8 cases(21.05%) were effective, and 8 cases(21.05%) were ineffective, with a total effective rate of 78.95%. The total effective rate of cervical softening in the vaginal administration group was higher than that in the oral administration group, and the difference was statistically significant(P<0.05). In vaginal administration group, 30 cases(78.95%) of uterine dilation pain were grade Ⅰ, 5 cases(13.16%) were grade Ⅱ, 2 cases(5.26%) were grade Ⅲ, and 1 case(2.63%) was grade Ⅳ, 20 cases(52.63%) were grade Ⅰ, 8 cases(21.05%) were grade Ⅱ, 6 cases(15.79%) were grade Ⅲ, and 4 cases(10.53%) were grade Ⅳ. The pain degree of uterine dilation in the vaginal administration group was lower than that in the oral administration group, and the difference was statistically significant(P<0.05). In the vaginal administration group, diarrhea occurred in 2 cases(5.26%), abdominal pain in 3 cases(7.89%), nausea and vomiting in 1 case(2.63%), headache and dizziness in 1 case(2.63%), and the incidence of adverse reactions was 18.42%;in the oral administration group, diarrhea occurred in 4 cases(10.53%), abdominal pain in 5 cases(13.16%), nausea and vomiting in 6 cases(15.79%), headache and dizziness in 2 cases(5.26%), and the incidence of adverse reactions was 44.74%. The incidence of adverse drug reactions in the vaginal administration group was lower than that in the oral administration group, and the difference was statistically significant(P<0.05).. Conclusion Vaginal administration of misoprostol before hysteroscopy can significantly improve the effect of cervical softening and relieve the pain degree of uterine dialation, and significantly reduce the incidence of adverse drug reactions, which is worthy of clinical promotion and application.