绝经妇女取IUD术前口服替勃龙临床效果观察

目的:对绝经妇女术前口服替勃龙取宫内节育器(IUD)和直接取器临床效果分析。方法:按照随机数字法抽取2012年1月~2014年1月于本科门诊就诊,要求取器的220例绝经期妇女,将其按照随机数字法随机分为观察组和对照组各110例,观察组就诊后嘱每日口服替勃龙2.5mg连服7d,第7天口服替勃龙2h后手术;对照组不用任何药物,直接手术。对两组宫颈软化程度、手术时间和出血量进行比较,记录观察组的不良反应,并统计两组取器成功情况并评定术中综合反应程度。结果:观察组取器顺利104例,取器困难4例,取器成功率为98.2%(108/110);对照组取器顺利85例,取器困难13例,取器成功率为89.1%(98/110)。观察组取器成功率高于对照组(χ2=18.707,P0.05)。观察组宫颈软化欠佳(2.7%,3/10),低于对照组(40.9%,45/110)(χ2=47.006,P0.05)。观察组术中综合反应程度为轻度占88.2%(97/110),高于对照组的64.6%(71/110)(χ2=17.024,P0.05);反应重度者占1.8%(2/110),低于对照组的12.7%(14/110)(χ2=9.706,P0.05)。观察组用药后未发现严重不良反应。结论:绝经期妇女服用替勃龙后取器,取器手术成功率高,可减少阴道出血及手术并发症,安全方便,值得临床推广使用。

A comparative analysis of intrauterine device removal with or without tibolone

Objective： To compare the clinical effects of intrauterine device （IUD） removal with or without tibolone. Methods： From January 2012 to January 2014 in our outpatient service department 220 menopausal women seeking for IUD removal were recruited and divided into the control group and the observation group according to the random number method, and 110 women in each group. Women in the observation group received 2.5 mg of tibolone daily for 7 days, and on the 7th day, the operation was done 2h after drug intake, while women in the control group were opera- ted directly with no use of the drug. The cervical softening degrees, operation time, blood loss, and successful rate of IUD removal of two groups were recorded and compared. Results： The successful rates of IUD removal in the observation group was 98.2% （108/110）, significantly higher than that of the control group （89.1%, 98/110, x^2 = 18.707, P〈0.05）. There were 3 cases （2.7 %） of poor cervix softening in the observation group, significantly lower than that of the control group （40.9%, 45/110, x^2 = 47.006, P〈0.05）. There were 97 women （88.2%） with mild side-effects in the observation group , significantly higher than that of the control group （64.6%, 71/110, x^2 = 17.024, P〈 0.05） ; And 2 cases （1.8 % ） of severe side-effects were found in the observation group, significantly lower than that of the control group （12.7%, 14/110, X2= 9.706, P〈 0.05） . No severe adverse reaction was found in the observation group. Conclusion.. There is higher success rate in menopausal women seeking for intrauterine device removal after taking tibolone. The drug could reduce incidences of vaginal bleeding and other complications, and it is also safe, convenient, and worthy of clinical promotion.