间苯三酚或戊酸雌二醇联合米索前列醇用于绝经2年以上妇女取器的临床效果

Effects of phloroglucinol or estradiol valerate combined with misoprostol on removal of IUD in postmenopausal women over 2 years

目的:探讨间苯三酚或戊酸雌二醇联合米索前列醇用于绝经2年以上妇女取出宫内节育器(IUD)的临床效果。方法:选择2019年11月-2022年3月本院就诊的绝经2~6年的取器妇女80例,随机分为间苯三酚静推联合舌下含服米索前列醇组(观察组)和戊酸雌二醇口服联合舌下含服米索前列醇组(对照组),比较两组的宫颈软化程度、疼痛评分(VAS)、手术时间、顺利程度、出血量、不适感等。结果:观察组取器时宫颈总软化率(100.0%)高于对照组(95.0%),取器时VAS评分优于对照组,平均手术时间(12.5±2.55)min短于对照组的(17.5±2.72)min,取器困难发生率(65.0%)低于对照组(87.5%),术中重度人工流产综合征发生率(7.5%)低对照组(17.5%)(P<0.05)。术中平均出血量两组无差异(P>0.05)。结论:间苯三酚静推联合舌下含服米索前列醇可以降低绝经2年以上妇女取器的困难发生率和重度人工流产综合征发生率,缩短手术时间。

Objective:To investigate and compare the effects of phloroglucinol and estradiol valerate both of which combined with misoprostol,respectively,applied in women with menopause over two years who had the surgical evacuation of an intrauterine device(IUD).Methods:80 women with menopause of 2-6 years who had the surgical evacuation of IUD and visited our outpatient clinic from November 2019 to March 2022 were selected as our observation subjects.These women were divided into two groups,one is phloroglucinol combined with sublingual misoprostol group(hereafter,the observation group)and another is estradiol valerate combined with sublingual misoprostol group(hereafter,the control group).Parameters including the degree of cervical softening,pain scores(VAS),operation time,smooth degree of operation,intraoperative blood loss,discomfort degree,etc.were compared for the two groups accordingly.Results:After the removal of IUD,the total softening degree of the cervix in the observation group(100%)is higher than that in the control group(95.0%),the VAS in the observation group(2.2)is better than that in the control group(3.1),the mean operation time in the observation group(12.5 minutes)is shorter than that in the control group(17.5 minutes),the occurrence rate of difficulty in removing IUD in the observation group(65.0%)is lower than that in the control group(87.5%),the incidence of severe induced abortion syndrome during operation in the observation group(7.5%)is lower than that in the control group(17.5%),indicating these differences between the two groups are of statistically significant(P<0.05).The intraoperative mean blood losses are 8.0mL and 9.1mL in the observation group and the control group,respectively,indicating the difference is of no statistically significant(P>0.05).Conclusions:The results show that the application of phloroglucinol injection combined with sublingual misoprostol in women with menopause over two years is able to reduce the occurrence rate of difficulty in removing IUD,the incidence of severe induced abortion syndrome during operation and the operation time,indicating this method is worthy of clinical popularization.