丙泊酚联合氯诺昔康在门诊无痛人工流产中的应用研究  

Application Research of Propofol Combined with Lornoxicam in Outpatient Painless Abortion

作　　者：赵治涛[1] 

机构地区：[1]山东省交通医院麻醉科,山东省济南市250031

出　　处：《中国全科医学》2013年第5期558-559,共2页Chinese General Practice

摘　　要：目的探讨丙泊酚联合氯诺昔康在门诊无痛人工流产中的应用效果。方法选择我院择期终止妊娠的早孕患者100例,简单随机抽样法分成两组,每组50例,Ⅰ组单纯静脉注射丙泊酚2.0 mg/kg;Ⅱ组静脉注射丙泊酚2.0 mg/kg,待患者睫毛反射消失后臀大肌注射氯诺昔康8.0 mg;以上两组均至患者呼之不应且睫毛反射消失后开始手术,若有体动,则每次追加丙泊酚1.0 mg/kg直至手术完成。观察患者麻醉前、麻醉后2 min、恢复清醒时的生命体征〔收缩压(SBP)、舒张压(DBP)、心率(HR)、脉搏血氧饱和度(SPO2)和呼吸频率(R)〕,记录丙泊酚总用量,患者苏醒时间,恶心、呕吐、呼吸抑制、术中肢动等不良反应及宫缩痛的发生情况。结果两组患者麻醉前、麻醉后2 min、恢复清醒时生命体征及恢复清醒时间组间比较,差异均无统计学意义(P>0.05)。Ⅱ组术中丙泊酚总用量,恶心、呕吐发生率、发生呼吸抑制例数、出现术中肢动例数均少于Ⅰ组;宫缩痛发生率Ⅱ组亦少于Ⅰ组,差异均有统计学意义(P<0.05)。结论丙泊酚联合氯诺昔康用于门诊无痛人工流产较单独应用丙泊酚有更好的麻醉效果,不良反应少、用量小,值得临床推广。Objective To investigate the effect of the application of propofol combined with lomoxicam in outpatient painless abortion. Methods 100 early pregnancy patients who wanted to implement elective abortion in our hospital were ran- domized into two groups equally. The patients in group Ⅰ received purely intravenous injection of propofol （ 2. 0 mg/kg） ; The patients in groupⅡalso received intravenous injection of propofol （2. 0 mg/kg） , and after the patient＇s eyelashes reflection dis- appeared, give the patients lornoxicam （8.0 mg） by intramuscular injection. All the surgery were implemented after the pa- tients lost consciousness and the eyelashes reflection disappeared. If the patients had body movement reaction, gave intravenous bolus of propofol （1.0 mg/kg） until the surgery was finished. Record the SBP, DBP, HR, R, SPO2 of three time points： before anesthesia, 2 rain after the patients lost consciousness and time of the patients awake from anesthesia. Also record the do- ses of propofol, the patient＇s awaking time from anesthesia, the adverse reactions during the surgery （include the ratio of nausea and vomiting incidence, respiratory depression, body movement） and the degree of uterine contraction pain. Results There weres no significant differences between the two groups of SBP, DBP, HR, SPO2 , R （P 〉 0. 05）. The doses of propofol, the patient＇s awaking time from anesthesia, the adverse reactions during the surgery and the degree of uterine contraction pain of group Ⅱ were significantly lower than group Ⅰ （ P 〈 0. 05 ）. Conclusion Compared with the anesthesia method of purely propo- fol intravenous injection, the effect of the application of propofol combined with lornoxicam in outpatient painless abortion is much better, and the complications were much less and is worth to be promoted.

关 键 词：丙泊酚 氯诺昔康 无痛人工流产 门诊 

分 类 号：R719.1[医药卫生—妇产科学]