两种镇痛方法用于人工流产术的临床效果  

Effect of Two Methods of Anaesthesia on Induced Abortion

作　　者：娄若康 姜玉娟[1] 王宁[1] 李玉珍[1] 刘源洁[1] 

机构地区：[1]吉林省计划生育科研所,长春130041

出　　处：《中国计划生育学杂志》2006年第7期428-429,共2页Chinese Journal of Family Planning

摘　　要：目的：总结分析异丙酚配伍芬太尼、氯胺酮配伍安定用于无痛人工流产的临床效果。方法：将378例自愿终止妊娠的早孕妇女分为A组238例，静脉推注异丙酚2．0～2．5mg／kg、芬太尼0．05mg，其中132例推注异丙酚速度为30-40mg／min，106例为50～60mg／min；B组140例，静脉推注安定5mg后再推注稀释后的氯胺酮0．3～0．5mg/kg。观察记录两组镇痛效果、术中出血量、宫颈松弛和呼吸抑制情况。结果：A组术中无痛率为93．70％，B组为90．71％，两组差异无显著性意义；A、B两组宫颈扩张无阻力分别占86．97％、86．43％，差异也无显著性意义；术后苏醒时间B组长于A组，差异有显著性意义。在A组中，异丙酚推注速度为50～60mg／min的106例中发现呼吸暂停5例，而速度为30～40mg／min的132例无一例发生呼吸暂停。结论：异丙酚配伍芬太尼和氯胺酮配伍安定静脉注射用于无痛流产术效果满意，前者减慢异丙酚的推注速度（30～40mg／min）可以减少呼吸暂停的发生，而后者术后苏醒时间长。Objective： To analyze the effect of Proprofol combined with Fentanyl, and Ketamine combined with Diazepam on induced abortion. Methods： 378 women who asked for induced abortion were divided into two groups. 238 women in group A had intravenous injection of 2.0 -2. 5mg/kg Proprofol at speed of 30 -40 mg/min （132 cases） and at speed of 50 -60mg/ min （ 106 cases） and Fentanyl 0.05 mg. 140 women in group B were injected into 5 mg Diazepam and 0.3 -0.5mg/kg Ketamine. The anaesthesia effect, respiratory and circulatory system, cervical dilatation and blood amount were observed. Results： The analgesia rates in group A and B were 93.70% and 90.71%, and the cervical dilatation without resistance in group A and B was 86.97% and 86.43%. There was no significant difference between two groups. But the revival time after operation in group B was longer than that in group A. In group A, there was 5 cases of apnea injected at speed of 50 - 60 mg/min, and there was no cases of apnea in the other women. Conclusion： Intravenous injection of Proprofol combined with Fentanyl, and Ketamine combined with Diazepam for the induced abortion have a satisfactory analgesia effect. The former at lower speed of injection（ 30 -40 mg/min） can obviously reduce the apnea, while the latter has longer revival time after operation.

关 键 词：人工流产 异丙酚 氯胺酮 芬太尼 安定 术中镇痛 

分 类 号：R169.4[医药卫生—公共卫生与预防医学]