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目的探讨B超监测联合尼尔雌醇配伍米索前列醇用于剖宫产妇女绝经后宫内节育器(intrauterine contraceptive device,IUD)取出困难的临床观察。方法将2008～2011年来彭州市计划生育服务站的剖宫产绝经后取器困难的妇女146例分为A,B两组,每组各73例。所有患者于术前7天每日顿服尼尔雌醇4mg,A组手术当日术前2h置米索前列醇0.4mg于阴道后穹隆。观察两组患者手术时间,宫口大小及术中出血量。结果两组取器成功率差异无统计学意义(P>0.05);A组手术时间短于B组,宫口开大情况好于B组,术中出血量少于B组,其差异均有统计学意义(P<0.05)。结论对剖宫产绝经后取IUD困难的妇女,术前采用尼尔雌醇配伍米索前列醇软化及扩张宫颈,B超监测下取器成功率高,术中出血少,手术时间短,并发症少,是广大剖宫产妇女绝经后取器的一种好方法。
Objective To investigate the clinical observation of using B-ultrasound in combination with nilestriol and misoprostol for removing intrauterine contraceptive device (IUD) in women with cesarean section. Methods A total of 146 women with difficulties in taking cesarean section at the family planning service station of Pengzhou from 2008 to 2011 were divided into A and B groups, with 73 cases in each group. All patients in the 7 days before surgery daily nalizol 4mg, A group on the day before surgery, 2h misoprostol 0.4mg vaginal posterior fornix. The operation time, cervix size and intraoperative blood loss were observed in two groups. Results There was no significant difference in success rate between two groups (P> 0.05). The operation time in group A was shorter than group B, the situation of cervix opening was better than group B, and the amount of bleeding during operation was less than that in group B Statistical significance (P <0.05). Conclusion For women with IUD after cesarean section taking postmenopausal women, preoperative use of nilestriol with misoprostol softens and dilates the cervix. The successful rate of B-ultrasonography is high, less bleeding during operation, shorter operative time and complicated Disease less, the majority of cesarean women after menopause to take a good way.