绝经后妇女取环单独应用补佳乐的可行性研究

目的研究绝经后妇女取环单独应用补佳乐的可行性。方法将2011-05/2013-02月在作者医院门诊取环妇女120例,随机分为3组。观察1组为40例,取环术前1周每日口服补佳乐3 mg;观察2组为40例,除术前1周每日口服补佳乐3 mg外,术前2 h舌下含服米索前列醇200μg;对照组为40例,术前不用任何药物。记录3组取环术中宫颈软化、疼痛程度、出血、取环时间和取环结果,以及服用补佳乐后雌二醇(estradiol,E2)水平、子宫内膜情况。结果①观察1组及观察2组与对照组比较:宫颈软化好,术中疼痛程度轻,取环成功率高,术中出血量少,手术时间短,存在统计学差异(P<0.05);②观察1组及2组服用补佳乐后,E2水平明显增高,追踪1月后E2降至服药前水平。子宫内膜厚度用药前后均无明显差异。电话随访患者均无乳房胀痛、阴道流血情况。③观察1组与观察2组比较各项指标无明显差异(P>0.05)。结论绝经后妇女取环单独应用补佳乐能减轻患者痛苦,提高取环的成功率,比联合用药简单,适用人群更广泛。

Feasibility of Progynova in the Removal of Intrauterine Device in Postmenopausal Women

Objective To evaluate the feasibility of progynova in the removal of intrauterine device in postmenopa- usal women. Methods From May 2011 to February 2013, 120 women undergoing removal of intrauterine device （IUD） were randomly divided into three groups. Observation group i included 40 cases taking oral progynova 3rag daily for one week before operation. Observation group 2 included 40 cases additionally taking oral progynova 3mg daily for one week before surgery and receiving misoprostol 200/1g sublingual 2h before operation. Control group included 40 cases without any drugs before surgery. Cervical softening, the degree of pain, bleeding, operation time, and success rates of opera- tion, as well as estrogen levels, thickness of endometrium were compared among three groups. Results ① Compared with the control group, observation group 1 and 2 had better cervical softening, lighter degree of intraoperative pain, higher success rate, less blood loss, shorter operative time （P〈0. 05）. ② The estrogen levels were significantly in- creased after taking progynova and drop to the level before the application of progynova one month later. There was no significant difference in endometrial thickness before and after treatment. All the patients received telephone follow-up and none complained of breast tenderness or vaginal bleeding. ③There was no significant difference of the indexes between two observation groups （P〈0. 05）. Conclusion The application of progynova alone in postmenopausal women can allevi- ate the suffering of the patients and improve the success rate of IUD removal, which is more simple than combined medi- cation, and worth popularizing.