目的为绝经后取器寻找新的术前宫颈准备方法。方法收集783例绝经取器妇女的相关资料，取器时随机分为A、B、C 3组，A组于术前半月口服替勃龙2．5 mg ，隔日一次，总量17．5 mg ，手术当日术前2 h舌下含服米索前列醇400 mg ，术中置入宫颈扩张棒；B组常规消毒阴道后暴露宫颈，置入一次性宫颈扩张棒，5 min后取出；C组术前2 h舌下含服米索前列醇400 mg准备宫颈，比较3组取器术的临床效果。结果A组宫颈软化程度最好，均顺利取器，有轻度疼痛，手术时间短，出血少。B组次之，取器成功率为92．34％，均有轻度至明显疼痛。A、B两组宫口扩张大小、手术时间、出血量及成功率均优于C组，差异有统计学意义（P＜0．05）。结论术前、术中应用药物及宫颈扩张棒可提高取器成功率。%Objective To find a new method for the preoperative IUD removal among postmenopausal women . Methods 783 postmenopausal women were divided into A ,B ,C 3 groups .Group A was given tibolone with 2 .5 mg every other day from 2 weeks before the removal operation .2 h before the operation ,sublingual misoprostol of 400 mg was administrated ,cervical dilatation rod was used to dilate cervix during the operation .Group B reveived regular disinfection after exposure of the cervix ,vagina in one-time cervical dilation ,take out after 5 min ,and Group C was only treated with 400 mg sublingual misoprostol 2 h before the operation .The performance of the 3 different adminis-tration was compared .Results The best degree of cervical softening ,mild pain ,shorter operative time and less bleed-ing were observed in group A .Mild to significant pain were reported from group B ,and the success rate of IUD re-moval was 92 .34% .Compared to group C ,both group A and B were significantly better in terms of cervix dilation size ,operation time ,bleeding ,and the success rate(P<0 .05) .Conclusion Application of drugs and cervical dilation preoperative and intraoperative could improve the success rate of IUD removal .
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