目的:探讨绝经后妇女取宫内节育器(IUD)困难者安全、有效、快捷的取IUD方法。方法:将203例绝经后妇女取IUD困难者随机分为两组,对照组101例术前1周尼尔雌醇4 mg顿服,术前2 h阴道后穹窿放置米索前列醇400μg后行常规取IUD;观察组102例尼尔雌醇、米索前列醇用法同对照组,术前将宫术宁胶棒放入宫颈管内,5 min后取出胶棒常规施术。观察比较两组术中情况及取环结果。结果:术中宫颈软化扩张及综合反应情况观察组明显优于对照组,差异有统计学意义(P<0.01);取IUD时间观察组较对照组明显缩短,差异有统计学意义(P<0.01);观察组顺利取IUD率较对照组高、失败率较对照组低,差异有统计学意义(P<0.01)。结论:尼尔雌醇、米索前列醇、宫术宁胶棒三药联合用于绝经后取IUD困难者能充分软化扩张宫颈、减少减轻并发症、提高取IUD成功率,值得在临床推广应用。 Objective: To investigate the safe, effective and rapid method of IUD for postmenopausal women with intrauterine device (IUD). Methods: A total of 203 postmenopausal women with IUD difficulty were randomly divided into two groups. In the control group, 101 preoperative nilestriol 4 mg was given one week before operation, and 400 μg of misoprostol was placed in the posterior vaginal fornix 2 hours before operation Conventional IUD; 102 cases of observation group, nilestriol, misoprostol usage and control group, preoperative uterine glue stick into the cervix, 5 minutes after the removal of plastic stick routine operation. Observe and compare the two groups of intraoperative conditions and take the ring results. Results: The intraoperative cervical softening expansion and comprehensive response of the observation group was significantly better than the control group, the difference was statistically significant (P <0.01); take IUD time observation group was significantly shorter than the control group, the difference was statistically significant (P <0.01 ). The IUD rate in the observation group was significantly higher than that in the control group, and the failure rate was lower in the observation group than in the control group (P <0.01). CONCLUSION: Nilestriol, misoprostol, and Gongzhingningjiao three drugs combined with IUD after menopause can fully soften the dilatation cervix, reduce complications and improve the success rate of IUD, which is worthy of clinical application .