延长无痛人工流产术前阴道放置卡前列甲酯用药时间的疗效观察

目的对无痛人工流产患者术前阴道放置卡前列甲酯,观察不同用药时间、不同剂量对手术效果的影响。方法 2012年1-6月于我院计划生育门诊行无痛人工流产术的女性共1 000例,随机分成5组,每组200例,妊娠时间45⁶5 d。A组:术前1 h阴道后穹窿置卡孕栓0.5 mg;B组:术前1 h阴道后穹窿置卡孕栓1 mg;C组:术前2 h阴道后穹窿置卡孕栓0.5 mg;D组:术前2 h阴道后穹窿置卡孕栓1 mg;E组:术前不用药(对照组)。所有患者静脉麻醉下行人工流产术,术中判定宫颈软化情况及术中阴道流血量,观察不良反应。结果应用卡孕栓后,D组宫颈软化程度最满意,88%不需扩张可以直接手术,软化效果明显好于其他三组,差异有统计学意义(P<0.05)。而A、B、C三组软化效果亦明显好于E组。D组术中出血量明显少于其他四组(P<0.05)。A、B、C、D四组间严重不良反应出现的几率差异无统计学意义。结论卡前列甲酯术前1 h阴道放置软化宫颈疗效确切,能简化手术,并有利于进一步机械性扩张宫颈。而术前2 h放置时,不仅能更加有效地软化宫颈,更能有效减少术中出血量,且不增加严重不良反应出现的几率。

Effect of prolong using carboprost methylate per vagina before painless induced abortion

Objective To use carboprost methylate per vagina before painless induced abortion in different dosage and different time to survey its effect on the operation. Methods A total of 1 000 women,who were in preg-nancy 45~65 days and required painless induced abortion of their own free will from January to June in 2012 at family planning clinics of our hospital,were randomly divided into five groups,200 cases in each group. Group A：0. 5 mg car-boprost methylate per posterior fornix 1 h before operation;Group B：1 mg carboprost methylate per posterior fornix 1 h before operation;Group C：0. 5 mg carboprost methylate per posterior fornix 2 h before operation;Group D：1 mg carbo-prost methylate per posterior fornix 2 h before operation;Group E：no preoperative medication. All patients received in-duced abortion with intravenous anesthesia,then we observed the degree of cervical relax,the amount of bleeding during operation,the contraction of uterine and the side effects. Results 2 hours after using carboprost methylate,the degree of cervical relax in group D was the most satisfactory and better than that of group A,B,C（P〈0. 05）. 88% suction could be operated directly without further cervical dilation. The degree of cervical relax in group A,B,C were all better than that of group E（P〈0. 05）. The amount of bleeding during operation of group D was obviously less than that of the other four groups（P〈0. 05）. The side effects of the four groups were of no difference. Conclusion Using carbo-prost methylate 1 h before operation can cause cervical relax and make the induced abortion easier to dilate by instru-ment. Using carboprost methylate 2 h before suction make cervical relax better and reduce the amount of bleeding dur-ing operation more effectively,without increasing the side effect.