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一种新型吸引式宫颈牵开器在宫内节育器放置中的应用:一项初步可行性试验。

Use of a novel suction cervical retractor for intrauterine device insertion: a pilot feasibility trial.

作者信息

Turok David K, Simmons Rebecca G, Cappiello Benjamin, Gawron Lori M, Saviers-Steiger Jane, Sanders Jessica N

机构信息

Department of Obstetrics and Gynecology, University of Utah Hospital, Salt Lake City, Utah, USA.

Bioceptive, Inc, New Orleans BioInnovation Center, New Orleans, Louisiana, USA.

出版信息

BMJ Sex Reprod Health. 2018 Nov 5. doi: 10.1136/bmjsrh-2017-200031.

Abstract

INTRODUCTION

The Bioceptive suction cervical retractor (SCR) is a novel device that can replace the standard single-tooth tenaculum to place traction on the cervix. A feasibility trial was conducted on the device for intrauterine device (IUD) placement.

METHODS

Our three-stage feasibility process began with Stage 1, where the device was tested on in-vitro and ex-vivo samples. In Stage 2, 10 women received their IUD using the device. In Stage 3, a feasibility trial, we randomly assigned 25 consenting women to receive their IUD using either the Bioceptive SCR or the standard single-tooth tenaculum. In Stages 2 and 3, we collected pain scores using an electronically adapted 100-point visual analogue scale (VAS) at eight timepoints during and after the insertion procedure, as well as satisfaction and acceptability measures. The primary outcome was the pain score after attaching the SCR or tenaculum (VAS 3). Wilcoxon rank sum tests compared pain scores between devices.

RESULTS

In Stage 2, pain scores with the SCR were lower than historical controls with the single-tooth tenaculum. In Stage 3, the median VAS 3 pain scores were 31 and 57 for the intervention and control groups, respectively. The differences in pain scores were not statistically significant but the trend was to lower pain scores with the intervention. Reported patient satisfaction with the SCR device was 80% in Stage 2% and 90% in Stage 3.

CONCLUSIONS

The Bioceptive SCR has potential as an atraumatic alternative to standard cervical retractor devices for gynaecological procedures. These findings can guide point estimates for future clinical studies.

TRIAL REGISTRATION

NCT02283463.

摘要

引言

生物感知式吸引宫颈牵开器(SCR)是一种新型装置,可替代标准单齿子宫颈钳对子宫颈进行牵引。对该装置进行了宫内节育器(IUD)放置的可行性试验。

方法

我们的三阶段可行性过程始于第1阶段,在该阶段对该装置进行体外和离体样本测试。在第2阶段,10名女性使用该装置放置IUD。在第3阶段,即可行性试验阶段,我们将25名同意参与的女性随机分为两组,一组使用生物感知式SCR放置IUD,另一组使用标准单齿子宫颈钳。在第2阶段和第3阶段,我们在插入过程中和插入后八个时间点使用电子适配的100分视觉模拟量表(VAS)收集疼痛评分,以及满意度和可接受性指标。主要结局是附着SCR或子宫颈钳后的疼痛评分(VAS 3)。采用Wilcoxon秩和检验比较两种装置的疼痛评分。

结果

在第2阶段,SCR的疼痛评分低于使用单齿子宫颈钳的历史对照。在第3阶段,干预组和对照组的VAS 3疼痛评分中位数分别为31和57。疼痛评分差异无统计学意义,但干预组疼痛评分有降低趋势。在第2阶段,报告的患者对SCR装置的满意度为80%,在第3阶段为90%。

结论

生物感知式SCR有潜力作为妇科手术中标准宫颈牵开器装置的无创伤替代品。这些发现可为未来临床研究的点估计提供指导。

试验注册

NCT02283463。

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