无痛人流的临床研究  

Clinical study on painless induced abortion

作　　者：季永[1] 王厚清[1] 李宗权[2] 喻田[1] 

机构地区：[1]遵义医学院附属医院麻醉学教研室 [2]成都市第六人民医院麻醉科,四川成都610051

出　　处：《遵义医学院学报》2004年第6期544-546,共3页Journal of Zunyi Medical University

摘　　要：目的　观察异丙酚复合芬太尼或氯胺酮在无痛人流手术中的麻醉效果、不良反应 ,及其对呼吸循环功能的影响 ,探讨一种安全、有效的无痛人流麻醉方法。方法　选择人流患者 6 0例 ,随机分成A组、B组和C组 ,每组 2 0例。A组仅给予宫颈局部麻醉 ;B组静注阿托品 0 .2mg、芬太尼 2ug/kg复合异丙酚 1～ 1.5mg/kg ;C组静注氯胺酮 0 .5mg/kg复合异丙酚 1～ 1.5mg/kg。观察的变化 ,记录出血量 ,手术、苏醒时间 ,镇痛效果及不良反应。 结果　与对照A组相比 ,B、C组手术时间明显缩短 (P <0 .0 5 ) ,镇痛有效率高 (P <0 .0 5 ) ,血流动学稳定、不良反应少 ;B、C组比较 ,C组苏醒时间较长 (P <0 .0 5 )、术后兴奋多语发生较多 (P <0 .0 5 )。结论　异丙酚复合芬太尼或氯胺酮均为安全、有效、可行的无痛人流麻醉方法 ,异丙酚复合芬太尼用于无痛人流具有更多的优点。Objective To study the anesthesia effect of propofol combined fentanyl and propofol combined ketamin for painless induced abortion and and find a safe and effective anesthetic method. Methods 60 cases of ASA Ⅰ Ⅱ grade early pregnacy were equally arranged into 3 group randomly. Group A received 0.5% lidocaine cervical local anesthesia ; Group B received atropin 0.2 mg、fentanyl 2 μg/kg and propofol 1 1.5mg/kg intravenous injection;Group C received ketamin 0.5 mg/kg and propofol 1 1.5mg/kg. MAP、HR、SaO 2 change,the degree of pain,time of recorvery and complication were observed. Results Analgesic effect in observational group B、C was significantly higher than that in group A, the operative time in the observational group was obviously shorter than that in group A (P<0.05);the occurrence of induced abrotion syndrom in group A was 3(15%),group B、C hadn’t any induced abrotion syndrom (P<0.05);group B had a significantly better and faster revival(P<0.05). Conclusions Propofol combined fentanyl and propofol combined ketamin both were safe and effective way for painless induced abortion and the former was even better.

关 键 词：人工流产 异丙酚 芬太尼 利多卡因 氯胺酮 

分 类 号：R714.3[医药卫生—妇产科学] R714.21[医药卫生—临床医学]