无痛人工流产术与传统人工流产术的临床对比观察

目的　通过对无痛人工流产术与传统的有痛人工流产术进行临床对比观察 ,进一步肯定无痛人工流产术是一种很好的避孕失败的补救措施。方法　对 10 0例自愿选择无痛人工流产术的早孕妇女 ,给予芬太尼辅助丙泊酚静脉麻醉 ,同时选择 10 0例自愿选择传统人工流产术的早孕妇女 ,观察麻醉效果、人工流产综合征(RAAS)发生率、出血量、子宫收缩。并分别记录麻醉恢复及不良反应、麻醉和手术期间血压和心率变化。结果丙泊酚复合芬太尼用于人工流产术、起效快 ,镇痛效果明显 ,有效率达 10 0 % ,无 1例发生RAAS。两组病人在子宫收缩和出血量方面差异无显著性 ,但对孕周大于 8周 ,特别是B性超声提示可见胎芽时 ,两组在出血量上差异显著。麻醉恢复快、不良反应小 ,麻醉和手术期间血压和心率下降较明显 ,清醒后可迅速恢复。结论　无痛人工流产术是很好的避孕失败的补救措施 ,镇痛效果好 ,麻醉不良反应小、恢复快 ,不影响子宫收缩 ,不增加出血量 ,但对孕周大于 8周的病人应给予肌注催产素 ,减少出血。术中应特别重视心功能较差病人的心功能监测。

Comparison of artificial abortion under intravenous anesthesia and non-anesthesia

Objective To investigate whether the artificial abortion under anesthesia is a good method to terminate pregnancy. Methods After choosing the methods by their own will, 100 women with early pregnancy underwent artificial abortion after injection of Fentanyl and Kabi Fresenius intravenously, and the other 100 without anesthesia served as the control group.Effects of anesthesia, occurrence of RAAS, capacity of hemorrhage and uterine contraction were analyzed, as well as changes of BP, HR and SPO 2 before, during and after operation. Results No RAAS occurred.There was no difference of uterine contraction and capacity of hemorrhage between the two groups.But when the pregnant week was over 8, the capacity of hemorrhage increased.The women in the test group came back to consciousness quickly and few side effects were observed.BP and HR dropped once for a while, but could recover soon after consciousness. Conclusions Artificial abortion under intravenous anesthesia is a good method to terminate pregnancy, while oxytocin might be used to reduce blood loss for those with more than 8 pregnant weeks.