米索前列醇用于人工流产术宫颈预处理的疗效评价

目的:旨在探讨米索前列醇用于人工流产术宫颈预处理的疗效。方法:选择2008年1月～2009年6月龙泉驿区第一人民医院自愿要求人流的孕妇200例作为观察对象,根据是否应用米索前列醇进行宫颈预处理随机分为两组,观察组(宫颈预处理)和对照组(给予阿托品)各100例,比较两组的宫颈软化扩张程度、手术时间与术中出血量、人工流产综合征的发生率及疼痛比较。结果:观察组宫颈软化扩张显效率明显高于对照组(P<0.05);观察组手术时间、术中出血量明显少于对照组(P<0.05);观察组人流综合征发生率明显低于对照组,术中重度患者疼痛例数观察组明显少于对照组(P<0.05)。结论:米索前列醇用于人工流产术宫颈预处理疗效好,可以缩短手术时间,减少术中出血量,降低人工流产综合征的发生。     

米索前列醇用于人工流产扩宫颈的效果观察

<正> 常规负压吸引人工流产时,常因宫颈口过紧在机械性扩张宫颈时,引起受术者不同程度的下腹疼痛,尤以初孕妇为甚。米索前列醇(简称米索)具有促宫颈成熟,软化扩张宫颈及加强子宫收缩的作用,已广泛用于与米非司酮配伍终止早孕药物流产中。为解除初孕妇因宫口过紧所致人工流产疼痛及手术困难,我们在术前应用米索扩张宫颈并与放置宫术安栓比较,现报告如下。 资料与方法     

米索前列醇在人工流产术前应用的疗效观察

目的探讨米索前列醇在人工流产术前用于软化宫颈的临床疗效。方法回顾性分析我中心50例人工流产术前宫颈准备的临床资料。结果人工流产术前阴道后穹隆放置米索前列醇组与橡皮导尿管置于宫腔组比较,宫颈软化程度、子宫收缩情况、出血量、人工流产综合征的差异均有显著性(P<0.01)。结论人工流产术前阴道后穹隆放置米索前列醇,软化宫颈、扩张宫颈简便、安全、有效。     

米索前列醇在人工流产术前应用的疗效观察

目的探讨米索前列醇在人工流产术前用于软化宫颈的临床疗效。方法回顾性分析我中心50例人工流产术前宫颈准备的临床资料。结果人工流产术前阴道后穹隆放置米索前列醇组与橡皮导尿管置于宫腔组比较，宫颈软化程度、子宫收缩情况、出血量、人工流产综合征的差异均有显著性（P〈0．01）。结论人工流产术前阴道后穹隆放置米索前列醇，软化宫颈、扩张宫颈简便、安全、有效。     

米索前列醇用于人工流产术前扩张宫颈的临床观察

<正> 为了减轻吸宫术中受术者痛苦,缩短手术时间、预防人工流产综合征的发生,我站将米索前列醇(简称米索)口服用于吸宫前进行宫颈扩张,并对100例妇女进行临床效果观察。现将结果报告如下。     

米索前列醇在人工流产术中的应用

目的:探讨早孕妇女人工流产术前阴道放置米索前列醇对宫颈的扩张作用。方法:选择自愿终止妊娠的早孕妇女120例随机分为3组,于人工流产术前不同时间阴道放置或口服不同剂量的米索前列醇,观察术中扩宫难易程度、手术时间及手术并发症。结果:应用米索前列醇组术中无阻力扩宫的例数均明显多于未使用米索前列醇组(P<0.01),手术时间明显缩短(P<0.01),手术并发症少(P<0.01)。结论:术前1-2 h阴道放置米索前列醇100μg,可达到良好的宫颈扩张效果。     

人工流产术前应用米索前列醇的体会

目的：观察探讨米索前列醇在人工流产术前用于软化宫颈的临床效果及安全性。方法：分试验组、对照组,将50例妊娠45天～84天,要求行人工流产术的妇女随机分成2组,试验组25例用米索前列醇200ug于人工流产术前2h～6h置于阴道后穹隆;对照组25例无特殊处理。观察2组病例手术时宫颈软化程度、宫口大小、出血量、子宫收缩情况、人流综合症的发生率。结果：2组妇女宫颈软化程度、子宫收缩情况、出血量、人流综合征的差异均有显著性（P〈0．01）。结论：人工流产术前阴道后穹隆放置米索前列醇,软化宫颈、扩张宫颈简便、安全、有效,能有效减轻妇女人工流产时的痛苦,预防人工流产并发症的发生。     

米索前列醇用于人工流产术的临床观察

目的:观察米索前列醇在人工流产术时软化宫颈及镇痛的效果。方法:将行人工流产的178例随机分成两组,米索前列醇组108例人工流产前12h阴道置米索前列醇400μg,对照组70例人工流产前12h阴道置甲硝唑片剂0.4g。结果:米索前列醇组人工流产综合征发生率仅为9.3%,对照组为62.9%,米索前列醇组明显低于对照组,静息状态下视觉模拟评分米索前列醇组和对照组间差异有极显著的统计学意义。综合评价米索前列醇组和对照组间差异有显著的统计学意义。米索前列醇组,宫颈充分软化98例(83.1%)。结论:人工流产术前12h一次性阴道置米索前列醇400μg为方便、有效的软化宫颈的理想方法,可缓解人工流产术的疼痛,减少手术操作的难度及感染机会,值得临床推广应用。     

米索前列醇用于早孕人工流产的临床观察

目的比较米索前列醇用于早孕人工流产与单纯常规人工流产术2种终止早孕方法的临床效果。方法将258例孕周6~10w的早孕妇女分成两组,A组128例术前3h米索前列醇400μg,每片掰成两半,置阴道后穹隆;B组130例不用任何镇痛药物和宫颈扩张剂,按常规直接行人工流产术。结果A组扩宫时镇痛效果、吸宫时镇痛效果均明显优于对照组(P<0.01);A组人工流产综合征发生率明显低于对照组(P<0.01);A组扩张宫颈,吸刮宫腔两个手术操作时间均较对照组快(P<0.01);两组术中出血量比较,无显著性差异(P>0.05)。结论阴道置米索前列醇用于早孕人工流产术中有明显镇痛作用,减少了人工流产综合征的发生,而且手术时间短,对出血无影响。     

Buccal misoprostol for cervical ripening prior to first trimester abortion

Background

Cervical priming prior to uterine suction evacuation softens the cervix and lessens the force needed for dilation, thereby potentially reducing the probability of procedural complications. The use of buccal misoprostol has been shown to be an adequate cervical primer in second trimester surgical procedures, but its use in first trimester aspiration procedures is not well documented. Our objective was to assess the necessity of manual dilation of the cervix when buccal misoprostol is used for cervical priming prior to first trimester uterine aspiration procedures.

Study Design

Retrospective case review of 685 patients who underwent a first trimester aspiration abortion with buccal misoprostol cervical priming from August 24, 2006, to February 23, 2007. All procedures were performed by three experienced physicians.

Results

Adequate dilatation of the cervix was achieved in 44.2% patients. The proportion of patients with adequate dilation decreased with increasing gestational age. Patients requiring additional mechanical dilatation differed significantly between those who were parous (51.0%) and those who were nulliparous (72.4%) (p<.001).

Conclusion

Buccal misoprostol appeared to decrease our need for manual dilation prior to first trimester aspiration abortion. Earlier gestations and parous patients showed less need for manual dilitation than later gestations or nulliparous women. A larger study with a control group is needed to confirm the benefit of the use of buccal misoprostol in first trimester aspiration abortion.     

宫颈环扎术治疗宫颈机能不全的疗效观察

目的探讨宫颈环扎术治疗妊娠期宫颈机能不全的疗效。方法 28例确诊妊娠合并宫颈机能不全者,16例施行宫颈环扎术治疗,观察妊娠结局。结果施行宫颈环扎术的16例孕妇中,延长妊娠至足月8例,早产6例,流产2例,胎儿成活12例;与非手术组差异有统计学意义（P〈0.01）。结论宫颈机能不全行宫颈环扎术可以延长孕妇的孕周,提高胎儿的成活率。     

Misoprostol as the primary agent for medical abortion in a low-income urban setting

The purpose of this study was to assess the outcomes of early medical abortion in an inner-city hospital abortion service, using misoprostol as the primary agent. This was a retrospective chart review from July 2001 through December 2002. Women were eligible if they had a viable pregnancy with gestational age 8 weeks or less by transvaginal ultrasound and no medical contraindications. Two doses of 800 microg misoprostol were administered vaginally, 24 h apart. Initial follow-up was scheduled 2-3 days later. Of the 440 women who underwent medical abortion, 373 (90.8%, 95% confidence interval (CI) 88-94%) completed abortion medically, 38 (9.2%) had uterine aspiration and the remainder had incomplete or no follow-up. Of uterine aspirations, 11 were medically indicated, giving a rate of indicated aspiration of 2.7%. Gestational age, age, gravidity, parity, past abortion history, ethnic group and payer did not significantly correlate with overall rate of aspiration or rate of follow-up, but gestational age was correlated with medically indicated aspiration. Among 57 women who reported a time of tissue passage, the mean time from initial misoprostol dose was 8.5 h (95% CI 6.5-13 h).     

Serious adverse events associated with the use of misoprostol alone for cervical preparation prior to early second trimester surgical abortion (12-16 weeks)

BACKGROUND: The purpose of this study was to determine the rate of serious adverse events (SAEs) occurring during early second trimester surgical abortion performed following the use of misoprostol alone for cervical preparation. STUDY DESIGN: A retrospective review was undertaken of 6620 elective surgical abortions performed between 12 and 16 weeks estimated gestational age during a 68-month period following cervical preparation with misoprostol alone. Information was obtained from a computer-based practice management system. RESULTS: During the study period, four SAEs occurred: three uterine perforations and one case of hemorrhage secondary to placenta accreta. The perforation rate was 0.45 (95% CI=0.09-1.32) per 1000 abortions. CONCLUSION: This review of our experience with surgical abortion performed from 12 to 16 weeks estimated gestational age following cervical preparation with misoprostol alone shows that the rate of SAEs, specifically uterine perforation, in this group was no greater than that previously reported in the literature.     

优美特宫颈扩张棒用于置(取)宫内节育器及人工流产术前扩张宫颈的临床效果观察

目的:观察优美特宫颈扩张棒用于置(取)宫内节育器(IUD)及人工流产术前扩张宫颈的临床效果和不良反应。方法:将要求置或取宫内节育器,妊娠10周负压吸引人工流产术需扩张宫颈的妇女275例随机分为两组,观察组(137例)为应用优美特宫颈扩张棒,对照组(138例)为应用宫术宁胶棒,观察两组术中宫颈软化扩张情况、镇痛效果、综合反应程度,术后20d随访。结果:观察组和对照组置或取IUD扩张宫颈效果分别为100%、96%,无统计学差异(P0.05),人工流产和绝经期取IUD扩张效果观察组优于对照组(P0.05),置入时疼痛发生率(4%、25%)有差异(P0.05);留置时疼痛发生率均较低,两组无统计学差异(P0.05),术后随访两组均无与产品相关的不良记载。结论:优美特宫颈扩张棒扩张效果可靠、安全,适用于置(取)IUD、妊娠10周内负压吸引人工流产术术前扩张宫颈。     

宫颈机能不全孕妇行宫颈环扎术的时间对妊娠结局的影响

目的:探讨不同妊娠周数时行宫颈环扎术对治疗宫颈机能不全的疗效。方法:回顾性分析宫颈机能不全而行U字型宫颈环扎术的29例患者的妊娠结局,分析母儿预后与手术时间的关系。以妊娠18周为界,分成两组:A组,妊娠12～18周时手术,16例;B组,大于妊娠18周手术,13例。比较两组间早产、胎膜早破及宫腔感染率的差异。结果:A组的早产、胎膜早破及宫腔感染率分别为6.25%、12.50%和0%;B组分别为23.08%、30.77%和15.38%;两组相比差异显著(P<0.05)。结论:宫颈机能不全病人,妊娠18周前行U字型宫颈环扎术是较理想的手术时机。     

宫颈环扎术治疗宫颈机能不全的临床价值

目的评价宫颈环扎术治疗宫颈机能不全的临床价值。方法选取2007年1月。2008年3月解放军总医院妇产科20例因宫颈机能不全行宫颈环扎术的患者。宫颈环扎术在孕15～23周实施．本院的手术方式与传统的宫颈环扎术有所不同,采取了宫颈双“U”宇型缝合,术前、术后辅助保胎治疗。结果20例患者中,行预防性宫颈环扎术18例,补救性宫颈环扎术2例。其结局为1例晚期流产;2例34周前早产,其中1例为孕33“周早产,新生儿体重1905g,另1例为孕31n周早产,新生儿体重l740g,均存活良好;另外17倒均于34周后分娩,新生儿均存活良好。20例患者均无胎膜早破和感染等术后并发症。结论宫颈环扎术是治疗宫颈机能不全、预防反复晚期流产和早产的有效方法。     

不同剂量米索前列醇口服和阴道给药对宫颈扩张的观察

目的:比较人工流产负压吸引术前2小时不同剂量米索前列醇口服与阴道内放置对宫颈扩张的临床效果。方法:共收集对象500例,随机分为I组(口服400μg),Ⅱ组(口服600μg),Ⅲ组(阴道给药400μg),Ⅳ组(阴道给药600μg)和Ⅴ组(对照组)各100例。结果:四个实验组与对照组比较,扩宫效果均有高度显著性差异(P<0.01),四个实验组比较扩宫效果无明显差异(P>0.05)。同一剂量口服组和阴道组比较,阴道组胃肠道副反应发生率低(P<0.01)。两个口服组或两个阴道组比较,400μg组胃肠道副反应发生率低(P<0.05)。结论:米索前列醇无论口服或阴道给药对于早孕妇女均有明显扩张与软化宫颈作用,可减轻疼痛,缩短手术时间,减少人工流产综合反应的发生,副反应轻,值得推广。400μg米索前列醇阴道用药可作为人工流产前宫颈扩张的最佳有效剂量和理想给药途径。     

人工流产术后阴道出血时间延长的临床与超声对照分析

目的:探讨人工流产术后阴道出血时间延长的原因及评价B超的辅助诊断价值。方法:收集76例术后阴道出血时间>10天者进行加强宫缩抗感染治疗,通过二维B超、必要时彩色多普勒超声协助诊断,有组织残留可疑者行清宫术,结果与超声进行对照分析。结果:术后阴道出血时间>10天者发生率为7.38%。其中66.67%的病人经加强宫缩抗感染治疗后阴道出血在15天内干净。二维B超明确诊断为组织残留者经清宫术后证实符合率为100.00%,疑为微量组织残留者经清宫术后证实符合率仅为33.33%,彩色多普勒超声协助诊断微量组织残留经清宫术后证实符合率为66.67%。结论:组织残留不是人工流产术后阴道出血时间延长的主要原因,彩色多普勒超声可为诊断困难者提供参考。     

宫腔镜电切手术中米索前列醇软化宫颈的效果浅析

目的 观察宫腔镜电切手术中米索前列醇软化宫颈的临床效果.方法 将我院在2011年1月-2013年1月收治的120例行宫腔镜电切手术患者随机分为两组,即观察组和对照组,每组各60例患者.观察组术前将400 μg米索前列醇放置于患者阴道后穹隆内;对照组术前进行利多卡因宫颈注射.观察对比两组患者的宫颈软化效果及手术并发症的情况.结果 观察组的宫颈软化效果明显优于对照组,差异具有统计学意义（P＜0.05）.结论 米索前列醇应用于宫腔镜电切手术软化宫颈的临床效果十分显著,具有良好的软化宫颈的效果,值得在宫腔镜电切手术中推广、应用.