米索前列醇联合杜冷丁及利多卡因在人工流产术中无痛效果分析

目的观察米索前列醇联合杜冷丁及利多卡因用于人工流产术的镇痛、扩宫效果。方法选择自愿行无痛人流术而无手术禁忌症,无米索前列醇应用禁忌症的早孕妇女360例,随机分为A组（米索前列醇术前舌下含化,杜冷丁术前肌肉注射联合利多卡因术时宫旁注射）和B组（笑气组）,每组180例观察两组镇痛效果、人流综合症发生率、术中宫口扩张的情况、术中出血量及子宫收缩情况。结果A组术中镇痛、扩张宫颈有效率明显优于B组,人工流产综合症发生率低于B组,两组相比差异有统计学意义（P〈0.05）,两组出血量比较差异无统计学意义（P〉0.05）。结论无痛人流术前4~6h舌下含化米索前列醇可达到良好的扩张宫颈作用,杜冷丁术前肌肉注射联合利多卡因术时宫旁阻滞可增强无痛人流术的镇痛效果,缩短手术时间。米索前列醇联合杜冷丁及利多卡因联合应用于无痛人工流产安全、简便、有效,尤其适用于基层医院推广应用。

Analysis on Analgesia Effect of Misoprostol Combined with Dolantin and Lidocaine in Artificial Abortion

Objective To observe the analgesia and cervix-dilating effect of misoprostol combined with dolantin and lidocaine in artificial abortion..Methods 360 early pregnant women voluntary to have painless artificial abortion,who had no contraindication to surgery and to misoprostol,were randomly divided into 2 groups: Group A and Group B,180 in each.The patients in Group A had sublingual misoprostol and intramuscular injection of dolantin before operation,and they had injection of lidocaine adjacent to the cervix in operation;the patients in Group B were given laughing gas.An observation was made to the analgesia effect,the incident rate of artificial abortion complications,the effective dilation of cervix,the intraoperative blood loss and uterine contraction in both groups.Results The analgesia effect and cervix dilation of Group A were superior to those of Group B,and the incidence of artificial abortion complications was lower than that of Group B,the difference was of statistical significance(P<0.05);the difference of intraoperative blood loss in the 2 groups was of no statistical significance(P<0.05).Conclusions Sublingual misoprostol 4 to 6 hours before operation can well help the cervix dilation,pro-operation intramuscular injection of dolantin plus the block adjacent to cervix of lidocaine in operation can increase the analgesia effect and shorten the operation time misoprostol combined with dolantin and lidocaine in painless artificial abortion is simple in performance and effective,worthy of wide application in primary hospitals.