【摘要】目的:比较昆布与米索前列醇对于育龄妇女宫腔镜术前宫颈扩张的效果与安全性。方法:156例患者随机分成3组,昆布扩张组52例患者术前宫颈内口放置3mm昆布棒,米索前列醇扩张组52例患者术前阴道后穹窿处放置米索前列醇200μg,机械扩张组52例患者术前使用Hegar扩张器扩张宫颈。结果:与阴道内置米索前列醇相比,昆布的使用增加了子宫和宫颈的长度,宫颈宽度没有增加。宫腔镜术后1个月子宫和宫颈的长度恢复到正常大小。机械扩张后的副反应是非常少的,昆布与米索前列醇引起的副反应是较多的。宫颈内置昆布棒在治疗后显著增加了宫颈管宽度。昆布扩张宫颈后需要额外宫颈扩张的病例数和额外扩张持续的时间与米索前列醇相比显著较少(P http://
【关键词】昆布;米索前列醇;宫颈扩张;宫腔镜术
Effectiveness of laminaria and misoprostol for cervical dilation before operative hysteroscopy in women of reproductive ageZHANG Hongbo, ZHANG Yi, ZHANG Yingzhong. Department of Obstetrics and Gynecology, Chang’an Hospital, Xi’an 710018, Shaanxi, China
【Abstract】Objectives: To compare the effectiveness and safety of laminaria and misoprostol for cervical dilation prior to operative hysteroscopy in women of reproductive age. Methods: 155 women participated in three groups randomly. For each of the 52 patients in laminaria dilation group, a single 3mm laminaria was inserted into the cervical canal. The 50 patients in the misoprostol dilation group received 200 mg intravaginal misoprostol into the posterior fornix. And the 50 patients in mechanical dilation used a Hegar dilator dilated cervical canal. Results: Intracervical laminaria increased uterine and cervical lengths but not the cervical width in comparison with intravaginal misoprostol; uterine and cervical lengths returned to their normal size one month after surgery. Adverse effects were fewer after mechanical dilation, and adverse effects were higher in patients administered intravaginal misoprostol and laminaria. The cervical canal widths were increased by intracervical laminaria preparation after treatment. The number of patients requiring additional cervical dilation and the duration of additional cervical dilation were substantially fewer after use of intracervical laminaria compared to intravaginal misoprostol (P [10]El-Mazny A, Abou-Salem N. A double-blind randomized controlled trial of vaginal misoprostol for cervical priming before outpatient hysteroscopy. Fertil Steril, 2011, 96(4):962-965.
[11]Bakas P, Hassiakos D, Liapis A, et al Misoprostol for cervical ripening before diagnostic hysteroscopy in nulliparous women. Int J Gynaecol Obstet, 2012, 116(3):263-264.
[12]Goldberg AB, Fortin JA, Drey EA, et al. Cervical preparation before dilation and evacuation using adjunctive misoprostol or mifepristone compared with overnight osmotic dilators alone: A randomized controlled trial. Obstetrics & Gynecology, 2015, 126(3): 599-609.
[13]Newmann SJ, Sokoloff A, Tharyil M, et al. Same-day synthetic osmotic dilators compared with overnight laminaria before abortion at 14-18 weeks of gestation: a randomized controlled trial. Obstetrics & Gynecology, 2014, 123(2, PART 1): 271-278.
[14]Lin YH, Hwang JL, Seow KM, et al. Laminaria tent vs misoprostol for cervical priming before hysteroscopy: Randomized study. J Minim Invasive Gynecol, 2009, 16(6):708-712.
[15]Karakus S, Akkar OB, Yildiz C, et al. Comparison of effectiveness of laminaria versus vaginal misoprostol for cervical preparation before operative hysteroscopy in women of reproductive age: A prospective randomized trial. Journal of Minimally Invasive Gynecology, 2016, 23(1): 46-52.