【摘要】 目的评价绝经后子宫出血患者宫腔镜术前不同宫颈预处理方法的临床效果。方法选取2017年2月至2018年4月北京老年医院妇科就诊的绝经后异常子宫出血需进一步行宫腔镜检查的患者,采用简单随机化法原则分为A、B、C 3组。A组术前10～15 min给予间苯三酚40 mg静脉注射,B组术前3 h舌下含服米索前列醇400μg,C组术前30 min舌下含服卡孕栓0.5 mg。比较各组宫颈软化情况、扩宫时间以及不良反应的发生情况。结果 89例患者纳入本研究,A、B、C组分别为30、30、29例,3组一般资料具有可比性。A组(66.67%)、B组(63.33%)宫颈软化的总有效率显著高于C组(24.14%),差异有统计学意义(P <0.05),A、B组的差异无统计学意义(P>0.05)。A组显效率(40.00%)显著高于B组(13.33%)和C组(6.90%),B组显著高于C组,差异均有统计学意义(P <0.05)。A组宫颈扩张时间为(16.0±6.2)s,B组为(18.2±5.0)s,C组为(21.5±4.5)s,3组比较差异有统计学意义(P <0.05),A组和B组扩宫时间均显著低于C组(P <0.05)。A组不良反应发生率为0,显著低于B组(63.3%)和C组(79.3%),差异均有统计学意义(P <0.05)。结论间苯三酚用于绝经后子宫出血患者宫腔镜手术的宫颈预处理具有使用简便、可控,不良反应少,效果良好的优点。更多还原

【Abstract】 Objective To evaluate the clinical effects of different cervical pretreatment methods of hysteroscopy in patients with postmenopausal uterine hemorrhage. Methods The patients with abnormal postmenopausal uterine hemorrhage in Beijig Geriatric Hospital from February 2017 to April 2018 were enrolled in the study. The patients were divided into 3 groups by simple randomization method. Group A received intravenous injection of phloroglucinol 40 mg, 10-15 min before surgery,group B received subglossal administration of misoprostol 400 μg, 3 h before surgery, and group C received subglossal administration of carboprost suppositories 0.5 mg, 30 min before surgery. The cervical softening, uterine dilation time and adverse reactions of each group were compared. Results A total of 89 patients were included in this study,there were 30, 30 and 29 cases in groups A, B and C, and the general data of the three groups were comparable. The total effective rates of the cervix softening in group A(66.67%) and group B(63.33%) were significantly higher than that of group C(24.14%), the difference was statistically significant(P < 0.05), there was no significant difference between group A and B(P > 0.05).The marked effective rate of group A(40.00%) was significantly higher than that of group B(13.33%) and group C(6.90%), the marked effective rate of group B was significantly higher than that of group C(P < 0.05). Cervical dilation time was(16.0±6.2) s in group A,(18.2±5.0) s in group B,(21.5±4.5) s in group C.The uterine dilation time of group A and group B was significantly lower than that of group C(P < 0.05). The incidence of adverse reactions in group A was 0, which was significantly lower than that of group B(63.3%) and group C(79.3%, all P < 0.05). Conclusions The application of phloroglucinol in cervical pretreatment of hysteroscopy for postmenopausal patients with uterine bleeding has the advantages of simple use, control, good effect and fewer adverse effects.更多还原