米索前列醇与利多卡因用于初孕妇人工流产术中扩宫镇痛效果的比较  

Comparison of pain-relieving effects of misoprostol and xylocaine on primigravidain abortion

作　　者：楼芝英 

机构地区：[1]浙江省杭州市计划生育宣传技术指导站,310005

出　　处：《世界今日医学杂志》2005年第3期153-155,共3页World JOurnal of Medicine Today

摘　　要：目的 探讨米索前列醇（简称米索）与利多卡因对初孕妇人工流产术的宫颈扩张及镇痛效果。方法 将停经6～10wk要求终止妊娠的400例初孕妇随机分为两组，米索组（200例）于术前2h舌下服米索200μg，官颈管内放置米索200μg，术前安定10mg静脉推注。利多卡因组（200例）术前用20g·L^-1利多卡因在宫颈3、9点两处分别注射2mL，再用棉签浸透20g·L^-1利多卡因液插入宫颈管内，待3～5min后取出棉签施术。观察记录用药后宫颈自然扩张程度、镇痛效果、术中出血量及人工流产综合征的发生情况。结果 ①宫颈扩张情况：米索组能顺利通过6号以上扩张器184例（92％），利多卡因组能顺利通过6号以上扩张器120例（66％），两组比较有显著差异（P〈0．01）。②镇痛效果：两组均达到理想的镇痛效果（P〈0．05）；③术中出血量：米索组出血量〉10mL仅19例（7．5％），而利多卡因组〉10mL达148例（74％），两组相比差异显著（P〈0．01）；④用药后副反应：米索组用药后绝大多数均有不同程度副反应，而利多卡因组几乎无副反应，两组相比，差异显著（P〈0．01）。结论米索和利多卡因均可起到人工流产术中扩宫和镇痛等效果，临床可根据患者的不同情况合理应用。Aim To study the pain-relieving effects of misoprostol and xylocaine on primigravida in abortion.Methods 400 primigravida after 6 ～ 10 weeks of menopause who asked for abortion were randomized into 2 groups.200 cases were in misoprostol groupwho were given 200 μg misoprostol under tongue, 200 μg were put in the cervical canal and 10 mg Valium was injected intravenously before operation. And 200 cases were in xylocaine group who were injected 20 g· L^-1 xylecaine at the spots of three and nine o＇ clock in the cervical canal before operation, then put a cotton stick which was soaked with 20g· L^- 1 xylocaine in the cervical canal, which was then withdrawn after 3 ～ 5minutes. After the use of the drug, the natural degree of enlargementeffect of pain relieving, amount of bleeding and the syndrome of abortion were recorded.Results ① Enlargement of cervical canal： In 184 cases（92%） in Misoprostol group 5/0.6 or above dilators could be used;In 120 cases（66%） in xylocaine group No.6 or above dilators could be used, and there was a significant difference between the two groups （ P 〈 0.01）. ② Pain relieving effect： There were the same effects in the two groups （P 〈0.01）. ③Amount of blecding： there were 19 cases（7.5%）in misoprostol group whose amount of bleeding was more than 10 mL while 148 in xylecaine group, and there was a significant difference between the two groups. ④Side effects：Most cases in misoprostol group had side effects of different degree, while almost no cases had side effects in xylecainegroup, and there was significant differenc between the two groups （P 〈 0.01）.Conclusion Misoprostol and xylocaine both can be used to relieve pain in the enlargement of cervical canal during the abortion, which can be used according to the different conditions of patients.

关 键 词：人工流产术 扩宫 镇痛 米索前列醇 利多卡因液 术中出血量 镇痛效果 初孕妇 宫颈扩张情况 人工流产综合征 

分 类 号：R169.42[医药卫生—公共卫生与预防医学] R764.450.5