安定与度冷丁配伍米索前列醇用于无痛人工流产术临床观察

Clinical observation of diazepam and Pethidine combined with misoprostol for analgesic artificial abortion

目的探讨安定与度冷丁配伍米索前列醇在无痛人工流产术中应用效果。方法选取安阳市第六人民医院2006年9月至2007年2月要求终止妊娠的早孕妇女200例,随机分为2组。观察组术前30 min给予米索前列醇0.2～0.4 mg舌下含化,以生理盐水开放静脉通路,度冷丁针0.8 mg.kg-1、安定0.08 mg.kg-1分别加入滴管,3～5 min开始手术。对照组常规消毒外阴、阴道、宫颈,分别在宫颈3点和9点处穿刺回抽无血后注射利多卡因针各2.5 mL,5 min后开始手术。观察2组的镇痛效果、宫颈松弛情况、人工流产综合征、手术时间及术中出血量。结果观察组无痛率、宫口完全松弛率明显高于对照组（P〈0.01）,人工流产综合征发生率明显低于对照组（P〈0.01）,术中平均出血量、平均手术时间明显低于对照组（P〈0.05）。结论安定与度冷丁配伍米索前列醇用于无痛人工流产术,可减少术中出血量,缩短手术时间,达到无痛人工流产的目的,且操作简便,费用低廉,值得临床推广。

Objective To explore the clinical effect of diazepam and pethidine combined with misoprostol for analgesic artificial abortion. Methods Two hundred pregnant women who wanted to terminate early pregnancy in the Sixth People＇s Hospital of Anyang,from September 2006 to February 2007 ,were randomly divided into two groups. The pregnant women in observation group were treated with 0.2-0.4 mg misoprostol by sublingual administration at thirty minutes before operation,the venous channel was opened with physiological saline, and 0.8 mg· kg^-1 pethidine and 0.08 nag· kg^-1 diazepam were injected into dropping pipette respeetively,then after 3 -5 min to start the operation. The conventional disinfection of cunnus,vagina and cervix was done in control group. The cervix was punctured and pumpback at the point of three and nine,when there was no blood, the eervix was injected 2.5 mL lidocaine needle respectively,then five minutes later to start operation. The effect of analgesic,degree of cervical looseness,artificial abortion syndrome,time of operation and volume of intraoperative hemorrhage were observed into two groups. Results The rate of aponia and degree of cervical looseness in observation group were significantly higher than these in control group（P 〈0.01 ）. And the rate of artificial abortion syndrome was significantly lower than that in eontrol group （ P 〈 0.01 ） ,The average volume of intraoperation hemorrhage and the average operation time were significantly lower than these in control group （ P 〈 0.05 ）. Conclusion The way of diazepam and pethidine combined with misoprostol for analgesic artificial abortion can reduce the volume of intraoperation hemorrhage,and shorten the operation time to achieve the purpose of analgesic artificial abortion with easy and low-cost.