术前米索前列醇与卡前列甲酯阴道放置对行宫腔镜手术子宫黏膜下肌瘤患者围手术期的影响

摘要

目的 探讨术前米索前列醇与卡前列甲酯阴道放置对行宫腔镜手术子宫黏膜下肌瘤患者围手术期临床指标、宫颈扩张程度及不良反应的影响.方法 研究对象选取义乌市妇幼保健计划生育服务中心2013年8月~2016年8月收治行宫腔镜手术子宫黏膜下肌瘤患者共150例,以随机数字表法分为A组(75例)和B组(75例),分别在术前给予米索前列醇与卡前列甲酯阴道放置;比较2组患者手术时间、术中出血量、胃肠功能恢复时间、宫颈扩张效果、宫颈内口扩张宽度及不良反应发生率等.结果 B组患者手术时间和术中出血量显著优于A组(P<0.05);2组患者胃肠功能恢复时间比较差异无统计学意义;B组患者宫颈扩张效果显著优于A组(P<0.05);B组患者宫颈内口扩张宽度显著多于A组(P<0.05);同时2组患者不良反应发生率比较差异无统计学意义.结论 行宫腔镜手术子宫黏膜下肌瘤患者术前卡前列甲酯阴道放置可有效缩短手术时间,减少手术出血,提高宫颈扩张效果,且未增加不良反应发生风险,价值优于米索前列醇.%Objective To investigate the influence of misoprostol and carboprost methylate for preoperative vaginal placement on the clinical index, the cervical dilatation degree and adverse reactions of patients with submucous myoma of uterus by hysteroscopic surgery.Methods150 patients with submucous myoma of uterus by hysteroscopic surgery were chosen in the period from August 2013 to August 2016 in Yiwu Maternal and Child Health Care Family Planning Service Center and divided into two groups including group A (75 patients) with misoprostol and group B (75 patients) with carboprost methylate for preoperative vaginal placement;and the operation time, the intraoperative blood loss, the recovery time of gastrointestinal function, the effects of cervical dilatation, the width of cervical dilatation and the adverse reactions incidence of both groups were compared.ResultsThe operation time and the intraoperative blood loss of B group were significantly better than A group(P<0.05).There was no significant difference in the recovery time of gastrointestinal function between the two groups.The effects of cervical dilatation in group B were significantly better than that in group A(P<0.05).The width of cervical dilatation in group B were significantly larger than that in group A(P<0.05).There was no significant difference in the adverse effects incidence between the two groups.ConclusionCompared with misoprostol, carboprost methylate for preoperative vaginal placement in the treatment of patients with submucous myoma of uterus by hysteroscopic surgery can efficiently shorten the operation time, reduce the operation bleeding, improve the effect of cervical dilatation and not increase the adverse reactions risk.