卡前列甲酯用于子宫腔疾病诊断术前宫颈预处理的疗效观察

目的探讨卡前列甲酯用于子宫腔疾病诊断术前宫颈预处理的效果。方法将2013年1～3月在北京妇产医院微创中心门诊行宫腔镜检查的275例患者随机分成2组,观察组141例,于术前30 min阴道放置卡前列甲酯0.5 mg;对照组134例,不用药。观察两组宫颈松弛情况、疼痛程度[(视觉模拟评分(visual analogue score,VAS)]、人工流产术后综合征(post artificial abortion syndrome,PAAS)发生率及宫腔镜检查时间。结果①观察组宫颈无阻力可通过扩张器号数[(6.9±1.3)mm vs(4.3±1.0)mm]、需要扩宫的例数(11.3%vs.54.5%)及扩宫时间[(16.71±10.4)s vs(48.64±17.8)s]与对照组比较差异均有统计学意义(P<0.05)。②观察组VAS评分[(2.8±1.2)vs(7.1±1.5)]、PAAS发生率(4.3%vs 36.6%)及宫腔镜检查时间[(2.7±1.0)min vs(5.5±1.1)min]均明显低于对照组(P<0.05)。③观察组药物相关并发症的发生率为15.6%,但症状轻微,多可自行缓解。结论卡前列甲酯能有效软化扩张宫颈,减轻患者疼痛,降低宫腔操作难度和并发症发生,是子宫腔内手术操作前进行宫颈预处理的有效方法。

Effectiveness of methyl carprost suppository for cervical ripening prior to diagnostic hysteroscopy

Objective To evaluate the effectiveness of methyl carprost suppository for cervical ripening before diagnostic hysteroscopy in premenopausal women. Methods From January 2013 to March 2013, 275 women who were undergone diagnostic hysteroscopy in Gynecology Minimally Invasive Center Beijing Obstetrics and Gynecology Hospital were randomly assigned into study group （n = 141 ） and control group （n = 134）. The cases in study group were given O. 5 mg methyl carprost suppository sublingually 30 mins before hysteroscopy. The extent of cervical ripening, pain scoring, incidence of post artificial abortion syndrome（PAAS） and procedural time were observed and compared. Results （l[）Mean cervical widths in the control and study group were （4. 3 ± 1.0） mm and （6. 9 ± 1.3） mm and showed a significant difference （P 〈 0.05 ）. The percentage of women requiring cervical dilatation （ 11.3 % vs. 54. 5% ） and the time for cervical dilatation required [ （ 16.71± 10. 4） s vs（48.64 ± 17.8 ） s] was significantly difference （P 〈 0. 05 ） between two groups. （2）The pain score was [ （2. 8 ± 1.2） vs （7. 1 ± 1.5 ） ], the incidence of PAAS （4.3% vs 36.6% ） and examining time [ （2.7 ± 1.0） rain vs（5.5 ± 1.1 ） mini was significantly lower in study group than those in control group （P 〈 0. 05 ）. （3）The incidence of complications was lower in study group than that in control group and most complication could relieve spontaneously. Conclusion Application of methyl carprost suppository sublingually before hysteroscopy is an effective method of cervical ripening before hysteroscopy.