丙泊酚联合芬太尼静脉麻醉在无痛人流中的应用观察(1)
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【摘要】 目的 观察丙泊酚联合应用芬太尼在无痛人流中的临床效果。 方法将388例符合入选条件并自愿要求人工流产者随机分为三组，A组178例，予丙泊酚+芬太尼麻醉；B组80例，予利多卡因麻醉；C组130例为对照组，不使用任何镇痛药物。观察三组镇痛效果、术中出血量以及人工流产综合反应发生情况。 结果 三组镇痛效果比较差异有统计学意义(P均<0.01)，A组镇痛效果最好。术中三组阴道出血量比较差异有统计学意义(P<0.05或0.01)，A组出血量最多。A组人工流产综合反应发生率为0，B组为2.5%，C组为13.9%，三组流产综合反应发生率比较差异有统计学意义(P<0.05或0.01)，A组效果最好。 结论丙泊酚联合应用芬太尼在无痛人流术是比较安全和理想的方法，但术中需注意子宫收缩情况，备好宫缩剂，防止大出血。
【关键词】 丙泊酚；芬太尼；人工流产综合反应；镇痛
文章编号：1003-1383(2010)06-0673-02 中图分类号：R 719.3+4 文献标识码：A
doi:10.3969/j.issn.1003-1383.2010.06.009
The clinical observation of propofol combined with fentanyl intravenous anesthesiain painless artificial abortion
YANGLingling
(The Chinese Medicine Hospital of Wujiang,Wujiang 215200,Jiangsu,China)
【Abstract】 ObjectiveTo observe the clinical effect of propofol combined with fentanyl intravenous anesthesia in painless artificial abortion.
Methods 388 cases those met the inclusion criteria and voluntarily requested for abortion were randomly divided into three groups. Group A (178 cases) was given propofol and fentanyl for anesthesia,group B(80 cases)was given the lidocaine anesthesia,the control group (130 cases) wasn't given any pain medication.the analgesic effect,amount of bleeding and the incidence of abortion syndrome were observed in three groups.
Results There was significant difference of Analgesic effect and the amount of bleeding and the incidence of abortion syndrome in three groups(P<0.05 or 0.01).Group A gained the best analgesic effect and the lowest incidence rate,but the amount of bleeding was the largest.
Conclusion The propofol combined with fentanyl intravenous anesthesia in painless artificial abortion is safe and ideal method. But we should pay attention to the condition of uterine contractions,preparing for the uterotonic and preventing massive hemorrhage.
【Key words】propofol；fentanyl；abortion syndrome；analgesia
随着生活水平的提高，人们对各种医疗操作的质量要求也越来越高。笔者对178例早孕妇女采用丙泊酚联合芬太尼静脉麻醉作用于无痛人工流产，取得了良好的临床效果，现报告如下。
资料与方法
1.一般资料 选择2008年1月～2009年6月在我院确诊早孕并自愿要求人工流产且无并发症及禁忌证者388例，年龄18～30岁，平均(23.01±3.21)岁，体重45～48 kg，平均(51.10±4.52)kg，宫内孕囊经B超证实孕龄45～60天，产次均为零。随机分为三组 ......
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