米索前列醇联合B超用于绝经后取器失败的临床观察

目的：观察米索前列醇联合B超用于绝经后因扩宫困难宫内节育器（ IUD）取出失败的临床疗效。方法将因扩宫失败IUD无法取出的妇女150例分为A、B两组，每组各75例。 A组术前4～6 h阴道后穹窿放置米索前列醇0．6 mg，取器全过程均在B超检测下进行；B组术前4～6 h口服米索前列醇0．6 mg，不用B超检测进行取器术。观察2组宫颈软化，取器成功，手术时间和术中出血量以及药物的不良反应。结果2组宫颈软化和取器成功率差异无统计学意义（P＞0．05）。 A组手术时间短于B组，术中出血量少于B组，2组比较差异有统计学意义（P＜0．05）。 A组药物不良反应少于B组。结论对于绝经后因扩宫困难取IUD失败的妇女，术前阴道后穹窿放置米索前列醇软化及扩张宫颈，B超全程监测下取IUD成功率高，手术时间短，术中出血少，并发症少，不良反应小，是绝经后取器的一种好的方法。

Clinical observation of application of misoprostol combined with B-ultrasonography for failure of postmenopausal IUD removal

Objective To study the clinical observation of application of misoprostol combined with B -ultrasonography for failure of postmenopausal IUD removal .Methods Women with failure of IUD removal due to difficulty in cervical dilation were divided into group A and group B ,each with 75 cases.In group A,0.6 mg misoprostol was put at the back of vagina 4~6 hours before operation .The whole process of removal was conducted under ultrasound detection .In group B,each case orally took 0.6 mg misoprostol 4~6 hours before operation .The whole process of removal was conducted without ultrasound detec-tion.The cervix softening , duration of operation , amount of bleeding and adverse drug reaction in the two groups were ob-served.Results There was no statistical significance between the two groups in terms of cervix softening rate and rate of re -moval success .The operation time of group A was shorter than that of Group B ,and also with less bleeding .There was signifi-cant difference between the two groups （P〉0.05）.Less adverse drug reaction occurred in group A than in group B （P〈0.05）.Conclusion For women with failure of IUD removal ,the operation, with misoprostol put at the back of vagina before operation to soften and expand the cervix and under the entire monitoring of B-ultrasonography ,has the advantage of high suc-cess rate , shorter operation time ,less bleeding ,fewer complications and side effects .