绝经后宫内节育器取出术的临床观察及护理

目的:探索戊酸雌二醇联合米索前列醇应用于绝经后女性宫内节育器取出的效果.方法:2009年3月～2010年12月,将已放置宫内节育器绝经后女性共302例,随机分成两组:研究组152例,口服戊酸雌二醇片1mg,每日1次,共7d;对照组150例,不给予药物.两组均术前30min将米索前列醇片400μg(捣碎)放入阴道后穹窿,术中采用BELSON700型全程超导可视下行取环术,术中观察宫颈软化情况、术中取出宫内节育器效果情况比较.结果:两组宫颈软化情况比较,研究组宫颈软化程度优于对照组,具有显著性差异性(P＜0.05)；两组术中取器效果比较.研究组术中顺利取器141例,困难取器11例；对照组术中顺利取器55例,困难取器94例,取器失败1例,具有显著性差异(P＜0.05).结论:给口服戊酸雌二醇片1mg,阴道后穹窿放入米索前列醇片400μg(捣碎),术中在全程超导可视下行取环术的操作,安全、可靠、成功率高,值得临床应用.

Clinical nursing for the patients with intrauterine device removal after menopause

Objectives: To explore the effect of estradiol valerate combined with misoprostol on postmenopausal women who removed intrauterine device(IUD).Methods: From March 2009 to December 2010,302 postmenopausal women who have had IUD inserted were divided into two groups at random.In the research group,there were 152 women who took 1 mg of estradiol valerate orally once a day and continued the medication for 7 days.In the control group,there were 150 women who were not given any medicine.Thirty minutes before the operation,400 mg of misoprostol tablets(smashed) were put into the vaginal vault of women in both groups.The visual B-ultrasound conducting technique was applied in the IUD removal procedure.The softening extents of cervix and the results of IUD removal were observed and compared between the two groups.Results: In the comparison of the softening extents of cervix in the two groups,we found significant better softening effects in the research group than in the control group(P<0.05).In the comparison of the operation results of IUD removal,the research group produced 141 cases of successful removal and 11 cases of difficult removal,while the control group showed 55 cases of successful removal,94 cases of difficult removal and 1 case of removal failure.There was significant difference(P<0.05).Conclusion: It proves to be safe,reliable and highly successful in the procedure of IUD removal by taking 1 mg of estradiol valerate orally,putting 400 mg of misoprostol tablets(smashed) into the vaginal vault and using the visual B-ultrasound conducting technique.