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目的探讨米索前列醇后穹窿放置联合宫腔内注射利多卡因在人工流产负压吸引术中的应用价值。方法选取2012年1月~2013年1月自愿到滕州市工人医院要求流产的孕妇100例作为研究对象,将其随机分为观察组和对照组,各50例。观察组采用术前2h阴道后穹窿放置米索前列醇片400μg、术时宫腔内注射2%利多卡因5ml下行人工流产;对照组采用芬太尼、丙泊酚静脉麻醉下人工流产,比较两组镇痛效果、宫颈松弛情况、术中出血、手术时间及近期并发症等相关指标。结果观察组、对照组镇痛有效率(96%,98%),人工流产综合症发生率(2%,6%)差异无统计学意义(P>0.05);宫颈扩张程度(96%,76%),术后2min离床率(100%,72%),脉搏下降[(4.02±0.79)次/min,(5.04±1.43)次/min],平均动脉压下降[(5.02±0.87)mmHg,(9.12±1.42)mmHg],术中出血量[(9.81±1.13)ml,(15.30±3.23)ml],手术时间[(125.00±3.79)s,(140.00±2.32)s],差异有统计学意义(P<0.01)。结论米索前列醇后穹窿放置联合利多卡因宫腔注射应用于人工流产负压吸引术,操作方法简单,费用低廉,安全性高,可以在基层医院大力推广应用。
Objective To investigate the value of misoprostol posterior fornix in combination with intrauterine injection of lidocaine for induced abortion. Methods From January 2012 to January 2013, 100 pregnant women who voluntarily went to workers’ hospital of Tengzhou City to ask for abortion were selected as study subjects, and randomly divided into observation group and control group, 50 cases each. In the observation group, 400 μg of misoprostol was placed in vaginal posterior fornix and 5 ml of 2% lidocaine injected intrauterinely during the operation. The control group was induced by intravenous anesthesia with fentanyl and propofol. Analgesic effect of two groups, cervical relaxation, intraoperative bleeding, operative time and recent complications and other related indicators. Results The effective rate of analgesia (96%, 98%) and the incidence of abortion syndrome (2%, 6%) in observation group and control group were not statistically significant (P> 0.05) (4.02 ± 0.79) / min, (5.04 ± 1.43) / min], and mean arterial pressure decreased (5.02 ± 0.87) mmHg (100%, 72% , (9.12 ± 1.42) mmHg], intraoperative blood loss [(9.81 ± 1.13) ml, (15.30 ± 3.23) ml], operation time [(125.00 ± 3.79) s, (140.00 ± 2.32) s] Significance (P <0.01). Conclusion Misoprostol posterior fornix combined with lidocaine intrauterine injection for abortion negative pressure suction technique has the advantages of simple operation method, low cost, high safety and can be widely applied in primary hospitals.