米索前列醇配伍戊酸雌二醇在宫腔镜术前的应用研究

目的：探讨绝经妇女宫腔镜术前应用戊酸雌二醇联合米索前列醇的作用。方法前瞻性研究2010年12月至2014年1月华亭县人民医院行宫腔镜检查的102例绝经妇女，根据随机数字表法分为3组，A组（34例）给予米索前列醇联合戊酸雌二醇，B组（34例）仅给予米索前列醇，C组（34例）不做任何处理。观察手术指标、治疗前后雌激素水平、子宫内膜厚度以及不良反应。结果 A组手术时间和出血量均显著少于B和C组（t值分别为3．29、6．47、6．10、10．42，均P＜0．05），B组手术时间和出血量均显著少于C组（t值分别为5．89、5．44，均P＜0．05）。 A组宫颈软化程度、疼痛评估均显著优于B和C组（χ2值分别为3．61、10．59、2．87、3．36，均P＜0．05），B组宫颈软化程度、疼痛评估宫颈软化程度均显著优于C组（χ2值分别为6．98、2．75，均P＜0．05），治疗后A组E2水平和子宫内膜厚度均大于B和C组（t值分别为5．32、5．02、8．79、9．50，均P＜0．05）。 A组术中不良反应少于C组（1例vs 8例），3组不良反应相比，差异具有统计学意义（P＝0．03）。结论绝经期妇女行宫腔镜术前应用米索前列醇联合戊酸雌二醇，有利于宫颈软化，减少手术时间和术中出血量，增加雌激素水平和子宫内膜厚度，并减少不良反应发生。

Combined application of misoprostol with estradiol valerate before hysteroscopy

Objective To investigate the role of misoprostol combined with estradiol valerate for postmenopausal women before hysteroscopy.Methods A total of 102 postmenopausal women were prospectively enrolled from December 2010 to January 2014, who were treated with hysteroscopy in People ’ s Hospital of Huating County .They were randomized into three groups by random number table .Group A (34 cases) was given misoprostol combined with estradiol valerate , group B (34 cases) was given misoprostol only, and group C (34 cases) was not treated .Operation indicators , estrogen levels and endometrial thickness before and after treatment , and adverse reactions were investigated .Results The operation duration and blood loss decreased significantly in group A compared with those in group B and group C (t value was 3.29, 6.47, 6.10 and 10.42, respective, all P<0.05), and those in group B were less than those in group C (t value was 5.89 and 5.44, respectively, both P<0.05).The degree of cervix softening and pain assessment in group A were superior to those in group B and group C (χ2 value was 3.61, 10.59, 2.87 and 3.36, respectively, all P<0.05), and those in group B were better than those in group C (χ2 value was 6.98 and 2.75, respectively, both P<0.05).The E2 levels and endometrial thickening after treatment increased significantly in group A compared with those in group B and group C ( t value was 5.32, 5.02, 8.79 and 9.50, respectively, all P<0.05).The adverse reactions in group A were less than those in group C (1 case vs 8 cases), and there was statistically significant difference among three groups ( P =0.03 ).Conclusion Misoprostol combined with estradiol valerate for postmenopausal women before hysteroscopy is favorable for cervix ripening .It can reduce operative duration and intraoperative blood loss and improve estrogen level and endometrial thickness .Furthermore, it alleviates adverse reactions .