选择性应用芬太尼在无痛人流术中2200例效果分析

目的通过选择性应用芬太尼配伍异丙酚及单用异丙酚两种静脉麻醉用于不同人群实施无痛人工流产术,与传统有痛人工流产术进行临床对比观察,进一步肯定异丙酚及芬太尼用于无痛人工流产术安全有效、不良反应少、方法简便。方法选择门诊自愿终止妊娠而无禁忌证的早孕妇女共2600例。按自愿选择将其分为无痛人工流产组两组A组320例（有痛经史妇女）、B组1880例和有痛人工流产组C组400例;无痛两组据受术者有无痛经史分别给予异丙酚配伍芬太尼静脉麻醉（A组）和异丙酚静脉麻醉（B组）,C组仅用1%地卡因宫颈局部麻醉,观察麻醉效果、术后宫缩痛发生率、人工流产综合征（RAAS）发生率、宫颈松弛情况、出血量及发生的不良反应等进行了临床对比研究。结果选择性应用芬太尼合并异丙酚用于人工流产术提高了镇痛有效率,A组有效率100%,B组有效率99.79%,C组有效率52.50%,AB两组与C组镇痛结果比较差异有统计学意义（P〈0.01）;降低了痛经患者术后宫缩痛发生率,镇痛两组术后宫缩痛发生率（1.11%）与C组（94.5%）分别比较差异有统计学意义（P〈0.01）。镇痛两组无一例发生人工流产综合征,与C组比较P〈0.01。三组对比宫颈松弛情况,阴道出血量,和发生的不良反应等差异无统计学意义。结论选择性应用芬太尼于无痛人流术中,最大限度地解决了每位患者的术中及术后痛苦,减少了并发症的发生,有推广应用价值。

Effect Analysis of Selectively Applied Fentanyl In the Anesthetic Induced Abortion Based On 2200 Induced Abortion Cases Du huimin

Objective: This paper purposes on comparison of Propofol accompanied Fentanyl and Propofol sololy applied in the Induced abortion by the Intravenous anesthesia with the traditioanal Induced abortion,fatherly confirming the advantage of using Propofol and Fentanyl in the Induced abortion :safety,better effect,little side effect,method simplifing.Methods:2600 abortion cases without complication were selected and divided into three groups according to the used anodynes.Group A contains 320 cases with dysmenorrhea using Propofol accompanied Fontanel vein injection,group B includes 1880 cases only with Propofol vein injection,and there 400 cases in group C only choosing 1% dicayin part anaaesthetic.Observe the analgesic effects,the cervix relaxing,vagina bleeding,RAAS occurring frequentcy and side effect.Results: The analgesic effect is enhanced by selectively appling Fentanyl accompanied Propofol in the anesthetic Induced abortion.The analgesic efficient rates are repectively 100% for group A,99.79% for group B and 52.50% for group C.Group A and B are different from group C upon their analgesic effects(P<0.01).Uterine pains occurring frequentcy reduce much during the dysmenorrhea patients:1.11% for group A and B compareatively 94.5% for group C.Group A and B are different from group C upon RAAS(P<0.01).Group A and B are not different from group C on the cervix relaxing,vagina bleeding and the side effect.Conclusion: It can reduce the patients' pains at length to selectively apply Fentanyl in the anesthetic Induced abortiona,and is great valuebale especially for the patients with dysmenorrhea.