米索前列醇对非妊娠妇女宫颈扩张效果的观察

VALUE OF MISOPROSTOL FOR CERVICAL DILATION FOR NONPREGNANCY WOMEN

目的 评价米索前列醇对非妊娠妇女宫颈扩张的效果。方法 将 10 0例宫腔镜电切术病人随机分成三组 :Ⅰ组 4 0例 ,米索前列醇 6 0 0 μg分两次置入阴道后穹隆 ;Ⅱ组 4 0例 ,米索前列醇 4 0 0 μg于术前 1天晚 9时放置 ;Ⅲ组 2 0例 ,米索前列醇 4 0 0 μg于手术日晨 6时放置 ,观察宫颈扩张情况、术者对手术操作的满意率、手术并发症以及药物副作用。结果 Ⅰ组病人全部可无阻力通过 9～ 11号Hegar氏扩张棒 ,术者操作的满意率为 10 0 % ,Ⅱ组 97.5 %的病人可无阻力通过 8.5～ 11号扩张棒 ,术者操作的满意率为 97.5 % ,Ⅲ组中75 %的病人需扩张宫颈 ,术者操作的满意率为 30 % ,与Ⅰ、Ⅱ组相比有显著性差异 (P <0 .0 1)。无 1例并发症发生 ,药物的副作用主要表现为轻微腹痛、阴道流血、发热等。结论 米索前列醇 6 0 0 μg分 2次放置以及4 0 0 μg于术前 1日晚 1次放置均可有效地扩张宫颈 ,其中 4 0 0 μg于术前 1日晚

Objective:To evaluate the effectiveness of vaginal misoprostol for cervical dilation for nonpregnancy women.Methods: A hundred women with definite intrauterine abnormalities were randomly divided into three groups.600 μg misoprostol were placed in the posterior vaginal fornix 12 hours and 3 hours before hysteroscopy in group Ⅰ (40 patients),and 400 μg misoprostol placed 12 hours before hysteroscopy in group Ⅱ (40 patients) and 4 hours before operation in group Ⅲ (20 patients) respectively. Cervical response, outcome,complications of operative hysteroscopy and side effects were assessed.Results:The cervical width estimated by Hegar dilator was almost the same between group Ⅰ (number 9～11) and group Ⅱ (number 8.5～11).In the group Ⅲ ,15(75%) patients needed cervical dilation. No complication was found. The side effects were mild lower abdominal pain, vaginal bleeding and increase in body temperature.Conclusions:600 μg misoprostol and 400 μg misoprostol placed 12 hours before hysteroscopy reduced the need for cervical dilation, facilitated hysteroscopy and minimized cervical complications.