绝经后妇女取出宫内节育器的临床观察

目的探讨绝经后妇女安全取出宫内节育器（IUD）的有效方法。方法将86例要求取出IUD的绝经后妇女随机分为两组。观察组43例,取环前给予结合雌激素0.625 mg,1次/d,连服7 d,于取环前2 h阴道前、后穹隆放置米索前列醇片400μg;对照组43例,不用任何药物。观察两组的宫口扩张情况、一次性取IUD的成功率、并发症、出血时间等。结果观察组的一次性取IUD的成功率为97.67%,高于对照组的16.28%（P〈0.01）。观察组的扩宫情况明显优于对照组,术后腹痛时间和术后出血时间均短于对照组（P〈0.01）。结论术前应用结合雌激素配伍米索前列醇可明显改善宫颈条件,减轻患者的疼痛,提髙绝经后妇女取环成功率,减少并发症,是一种安全有效的方法。

Clinical observation on removing intrauterine device in postmenopausal women

Objective To discuss the effective method to safely take out of intrauterine device（IUD） in postmenopausal women. Methods Eighty-six postmenopausal women asking for removing IUD were evenly divided into the two groups in random.In the observation group（n=43）,0.625 mg conjugated estrogen before taking out IUD was provided once per day for 7 consecutive days.Two hours before taking out IUD,400 μg misoprostol tablets were placed into vaginal anterior and posterior fornix.In the control group,no drug was applied.Cervical dilatation,the successful rate of taking out IUD once,complication and bleeding time and so on in the two groups were observed. Results The successful rate of taking out IUD once in the observation group（97.67%） was higher than that in the control group（16.28%）（P〈0.01）.Expanding uterus in the observation group was significantly better than the control group,the time of postoperative pain and postoperative bleeding time was shorter than the control group respectively（P〈0.01）. Conclusion Application of conjugated estrogen combining with misoprostol can remarkably improve cervical conditions,alleviate pain of patients,increase the success rate of removing IUD in postmenopausal woman, and reduce complication,which is a safe and effective method.