瘢痕子宫无痛人工流产术52例临床分析

The clinical analysis of scar uterus painless artificial abortion in 52 cases.

目的观察剖宫产术后瘢痕子宫无痛人工流产术的临床应用价值及安全性。方法将104例有剖宫产史的早孕患者随机分成两组,术前4h阴道均放置米索前列醇0.4mg。观察组52例,应用异丙酚复合芬太尼静脉麻醉;对照组52例,采用普通人工流产方法。对照两组手术中宫颈松弛度、腹痛情况、人工流产综合征(RAAS)的发生情况及术中出血量。结果宫颈松弛有效率,观察组96%,对照组81%,二者差异有统计学意义(P<0.01);剧烈腹痛,观察组0例,对照组8例,二者差异有统计学意义(P<0.01);RAAS的发生率,观察组0%,对照组20%,二者差异有统计学意义(P<0.01);出血量,观察组(42±14.3)ml,与对照组(38±12.1)ml比较,差异无统计学意义(P>0.05)。结论瘢痕子宫患者应用异丙酚复合芬太尼静脉麻醉无痛人工流产术是安全有效的方法,值得临床推广应用。

Objective To observe the clinical value and safety of the scar uterus painless artificial abortion.Methods 104 early pregnancy women who have history of cesarean section were randomly divided into two groups,both of them are placed misoprostol 0.4mg in vaginal preoperatively 4h.52 cases of the observation group,the application of propofol-fentanyl intravenous anesthesia.52 cases of the control group,the use of abortion as a method of the ordinary.To compare the laxity of cervical,abdominal pain,the RAAS occurrence and the bleeding volume in the surgery of the two groups.Results The efficient rate of cervical relaxation,the observation group 96%,the control group 81%,the difference was statisticaly significant（P0.01）;Severe abdominal pain,0 cases of the observation group,8 cases of control group,the difference was statistically significant（P0.01）;The RAAS incidence rate,0 cases of the observation group,20% of the control group,the difference was statistically significant（P0.01）;The bleeding volume,the observation group（42±14.3）ml,the control group（38±12.1） ml,the difference was not significant（P0.05）.Conclusion The application of propofol-fentanyl intravenous anesthesia in painless abortion for the scar uterus pregnant women is safe and effective.