不同种麻醉用于人工流产术1800例效果观察  

Analgesic Effects Of Different Anaesthetics Employed In The Induced Abortion Empirical Research Based On 1,800 Abortion Cases

作　　者：杜惠敏[1] 

机构地区：[1]泰安市中心医院,山东泰安271000

出　　处：《泰山医学院学报》2006年第4期316-318,共3页Journal of Taishan Medical College

摘　　要：目的近五年来,本院门诊手术室采用异丙酚,芬太尼等和传统的局部麻醉药1%地卡因分别用于人工流产术1800例。本文就其镇痛效果、宫颈松弛情况、出血量、人工流产综合征(RAAS)发生率及不良反应等进行了临床对比研究。方法选择门诊自愿要求人工流产而无禁忌证者共1800例。随意愿分为A组600例使用异丙酚静脉麻醉,B组800例应用芬太尼+阿托品+1%地卡因局部麻醉和C组400例只使用1%地卡因局部麻醉。结果镇痛有效率A组达100%,B组80.00%,C组52.50%;RAAS发生率A组无一例发生,B组2.25%,C组9.25%,AB两组分别与C组比较有非常显著性差异P<0.01。宫颈松弛程度,子宫收缩及阴道出血量三组比较无显著性差异P>0.05。结论异丙酚用于人工流产镇痛效果好,是理想安全的人流镇痛方法,但因其实施条件高,费用昂贵限制了基层医院和某些患者的选择;芬太尼镇痛效果良好仅次于异丙酚,但因其具有实施条件低,价廉且安全性高等优点也不失为各级医院和各层次患者选择的另一良好途径。两种静脉麻醉用于人工流产术的镇痛效果好且安全,有推广应用价值。Objective：During the last five years, -more than 1800 induced abortion cases have been conducted in the outpatient service department of our hospital, using Propofol, Fentanyl and traditional part anaesthetic medical 1% Dicane as anodynes respectively. This paper purposes on the comparison of the analgesic effects, the cervix relaxing, vagina bleeding, （RAAS） oceurring frequency and side effect along with three different anodynes. Methods： 1800 abortion cases without complication were selected and divided into three groups according to the used anodynes. Group A contains 600 cases with Propofol vein injection, group B includes 800 cases using Fentanyl,atropine plus 1% Dicane part anaesthetic, and there are 400 cases in group C only choosing 1% Dicane part anaesthetic as the anodyne. Results： The analgesic efficient rates are respectively 100% for group A, 80.00% for group B and 52.50% for group C. Group A results in zero RAAS, comparing with the occurring frequencies of which are 2.25e/f for group B and 9.25% for group C. Group A and B are different from group C upon their analgesic effects and RAAS occurring frequency under the confidence level of 1% and not different from group C upon the cervix relaxing, the uterus contracting and vagina bleeding under the confidence level of 5%. Conclusion： Propofol has the advantage compared with the other two anodynes in induced abortion and is the ideal one for the operation. But such therapy is limited in hospitals of basic levels and in the choice of ordinary patients by its high costs and complicated conducting terms. Fentanyl is sub - optimal to Propofol with its analgesic effect, but it can be a good choice for all kinds of hospitals and patients because of its low price, high security property and easy satisfying conducting requirements. These two therapies for analgesia in induced abortion have better analgesic effects and more security protection comparing with the traditional anodyne, so they should be put into clinical.

关 键 词：异丙酚 芬太尼 阿托品 人工流产 静脉麻醉 

分 类 号：R169.42[医药卫生—公共卫生与预防医学]