卡孕栓在宮腔鏡手術(shù)中應(yīng)用的臨床觀察

馬少平+孔麗娜

【摘要】 目的：探討宮腔鏡術(shù)前肛門(mén)內(nèi)放置卡孕栓擴(kuò)張宮頸的臨床效果。方法：選取2011年6月-2012年6月在本院行宮腔鏡手術(shù)且無(wú)禁忌證的200例患者，按照隨機(jī)數(shù)字表法將其分為卡孕栓組（A組）和米索前列醇組（B組）各100例，兩組均于術(shù)前2 h給藥，觀察比較兩組患者的宮頸松弛情況、手術(shù)時(shí)間及手術(shù)出血量。結(jié)果：兩組宮頸軟化均達(dá)到較好效果，但比較差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05）。A組子宮內(nèi)膜息肉、子宮黏膜下肌瘤的手術(shù)時(shí)間均明顯短于B組，手術(shù)出血量均明顯少于B組，差異均有統(tǒng)計(jì)學(xué)意義（P<0.01）。A組惡心、嘔吐發(fā)生率、腹痛發(fā)生率及發(fā)熱發(fā)生率均明顯低于B組，差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論：卡孕栓與米索前列醇均能有效地?cái)U(kuò)張宮頸，而卡孕栓能夠減少出血量，縮短手術(shù)時(shí)間，減少患者的副反應(yīng)，值得臨床推廣使用。

【關(guān)鍵詞】 卡孕栓； 宮腔鏡； 米索前列醇

Clinical Observation of Applications of Carboprost Suppository in Hysteroscopic Surgery/MA Shao-ping，KONG Li-na.//Medical Innovation of China，2014，11（28）：034-036

【Abstract】 Objective：To investigate the clinical effect of applying carboprost methylate to dilation of the cervix via anus placement prior in hysteroscopic surgery.Method：200 patients underwent hysteroscopic surgery and no contraindication in our hospital from June 2011 to June 2012 were selected，they were divided into the carboprost suppository group and the misoprostol group according to the random number table method，100 cases in each group.The two groups were respectively managed with the previous drug before surgery.The relaxation degree of the cervix，operative time and intraoperative blood loss of two groups were observed and compared.Result：The cervix softening achieved good effect in both groups，but there was no statistically significant difference between two groups（P>0.05）.The operative time of endometrial polyps，submucous myoma of uterus in group A were significantly shorter than group B，intraoperative blood loss of group A was significantly less than group B，the differences were statistically significant（P<0.01）.The incidence of nausea，vomiting，abdominal pain and fever in group A were significantly lower than those of group B，the differences were statistically significant（P<0.05）.Conclusion：Carboprost methylate and misoprostol can effectively expand the cervix，yet the former can reduce blood loss，shorten the operative time，reduce the patients adverse reactions，worthy of clinical use.

【Key words】 Carboprost； Hysteroscopy； Misoprostol

First-authors address：The First Affiliated Yijishan Hospital of Wannan Medical College，Wuhu 241001，China

doi：10.3969/j.issn.1674-4985.2014.28.012

隨著婦科微創(chuàng)技術(shù)的發(fā)展，宮腔鏡技術(shù)在女性宮腔病變?cè)\治中占有重要地位，使得許多患者免除切除子宮的痛苦。良好的宮頸軟化和擴(kuò)張對(duì)于保證手術(shù)順利進(jìn)行、縮短手術(shù)時(shí)間和減少術(shù)后并發(fā)癥是非常重要的?？ㄔ兴ㄊ墙陙?lái)較多用于宮頸預(yù)處理的藥物之一，臨床效果肯定。為觀察卡孕栓在宮頸預(yù)處理的作用及副反應(yīng)情況，筆者對(duì)2011年6月-2012年6月在本院行宮腔鏡手術(shù)的200例患者的臨床資料進(jìn)行回顧性分析，具體報(bào)告如下。

1 資料與方法

1.1 一般資料 選取2011年6月-2012年6月在本院行宮腔鏡手術(shù)且無(wú)禁忌證的200例患者作為研究對(duì)象，患者年齡21～65歲，其中包括子宮內(nèi)膜息肉、子宮黏膜下肌瘤、絕經(jīng)后子宮內(nèi)膜不明原因增厚（術(shù)前均診斷性刮宮排除子宮內(nèi)膜癌）等病因。按照隨機(jī)數(shù)字表法將所有患者分為卡孕栓組（A組）和米索前列醇組（B組）各100例，兩組患者的年齡、生育情況等一般資料比較差異均無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05），具有可比性差異無(wú)統(tǒng)計(jì)學(xué)意義，見(jiàn)表1。end……