丙泊酚联合瑞芬太尼静脉泵注对无痛人工流产早孕妇女认知功能影响的临床研究  

Effect of Intravenous Injection of Remifentanil Combined with Propofol on Cognitive Functions of Women Who Have Undergone Painless Induced Abortion

作　　者：汪琼[1] 佐满珍[1] 郑文斐[1] 

机构地区：[1]三峡大学人民医院妇产科,湖北省宜昌市443000

出　　处：《中国全科医学》2012年第11期1231-1233,共3页Chinese General Practice

摘　　要：目的观察丙泊酚联合瑞芬太尼静脉泵注对无痛人工流产早孕妇女的认知功能有无影响,并将丙泊酚联合瑞芬太尼静脉泵注对无痛人工流产早孕妇女的镇静、镇痛效果与丙泊酚联合芬太尼静脉泵注作一比较。方法选择2007年5月—10月自愿选择无痛人工流产终止妊娠的早孕妇女60例,随机分为丙泊酚联合瑞芬太尼静脉泵注组(A组)和丙泊酚联合芬太尼静脉泵注组(B组)两组,各为30例,并选择同期来我院自愿要求行非无痛人工流产术的早孕妇女20例作为对照组(C组),对3组早孕妇女术前1 h、术后1 h及术后1个月的认知情况进行问卷调查,并进行评分。分别记录3组用药前(T1)、扩张宫颈时(T2)、吸刮宫腔时(T3)、术毕即刻(T4)及孕妇清醒时(T5)5个时间点的心率、收缩压、舒张压变化。同时记录使用药物的A、B两组无痛人工流产早孕妇女发生不良反应的例数。结果 (1)3组间及组内手术前后认知功能比较,差异均无统计学意义(P>0.05)。(2)早孕妇女在T1、T2、T3、T4及T5 5个时间点的血流动力学变化3组间比较,差异无统计学意义(P>0.05)。(3)A组术后镇痛效果优于B组,术后仅C组出现5例恶心、呕吐的不良反应。结论丙泊酚联合瑞芬太尼静脉泵注应用于无痛人工流产镇静、镇痛效果好,对早孕妇女认知功能无影响,无不良反应,安全可靠。Objective To observe the effect of intravenous injection of propofol combined with remifentanil on the cognitive functions of women who have undergone painless induced abortion.Methods Totally 60 women who had undergone painless induced abortion from May 2007 to October 2007 were randomly divided into two groups：group A（n=30） received intravenous injection of propofol combined with remifentanil and group B（n=30）received intravenous injection of propofol combined with fentanil.Another 20 patients who had undergone painless induced abortion were randomly selected as control group（C group）.The cognitive functions 1 hour before operation and 1 hour and 1 month after operation were recorded by questionnaires.The circulatory parameters including heart rate（HR）,systolic blood pressure（SBP）,and diastolic bloodpressure（DBP） were recorded at five time points（T1,T2,T3,T4,and T5）.The sedative and analgesia effects and the side effects were compared between group A and group B.Results The cognitive functions showed no significant difference among these three groups 1 hour before operation and 1 hour and 1 month after operation（P〉0.05）.The hemodynamic parameters at T1,T2,T3,T4,and T5 also showed no statistically significant differences（P〉0.05）.Nevertheless,the analgesic effect in group A was better than that in group B.Postoperative adverse events（nausea and vomiting） were only observed in five patients in the group C.Conclusion Intravenous injection of propofol combined with remifentanil has satisfactory sedative and analgesic effects.It is safe and reliable and will not damage the patients′ cognitive function.

关 键 词：无痛人工流产 孕妇 瑞芬太尼 认知功能 

分 类 号：R719.34[医药卫生—妇产科学]