氟比洛芬酯对人流术后子宫收缩痛的影响

Effect of flurbiprofen axetil on the pain after artifical abortion

目的：观察氟比洛芬酯对人流术后子宫收缩痛的影响并分析其机制。方法：选择ASA（美国麻醉医师协会）分级Ⅰ-Ⅱ人工流产手术病人120例,随机分为4组（n=30）：50mg氟比洛芬酯复合异丙酚组（F50组）、75mg氟比洛芬酯复合异丙酚组（F75组）、氟比洛芬酯空白乳剂复合异丙酚对照组（C组）、氯胺酮复合异丙酚组（K组）。各组病人均于术前2h口服米索前列醇,F50、F75及C组均于注射异丙酚前5min注射相应剂量的氟比洛芬酯或氟比洛芬酯空白乳剂,K组直接注射氯胺酮与异丙酚的混合溶液。记录术中呼吸、循环参数及术后子宫收缩痛的VAS评分。结果：F50、F75两组术后宫缩痛的VAS（视觉模拟评分）评分在同一时间点均低于C、K组（P〈0.05）,与苏醒后5min比较,F50、F75两组从苏醒后15min开始术后宫缩痛的VAS评分即逐渐降低（P〈0.05）,而C、K组则是从苏醒后30min开始术后宫缩痛的VAS评分方逐渐降低（P〈0.05）。结论：氟比洛芬酯50mg、75mg能有效抑制人流术后子宫收缩痛,其机制可能是由于抑制了前列腺素的释放。

Objective：To investigate the effect of flurbiprofen axetil on the pain after artifical abortion and its mechanism. Methods： A total of 120 ASAⅠ-Ⅱ induced abortion patients were randomly divided into 4 groups（n=30 each）. Group F50 was treated with flurbiprofen axetil（50 mg） combined with propofol,Group F75 with flurbiprofen axetil（75 mg） combined with propofol,Group C with blank emulsion combined with propofol and Group K with ketamine combined with propofol.All patients took Misoprostol tablet by mouth 2 hours before artifical abortion, patients of group F50,group F75 and group C were intravenousely injected flurbiprofen axetil or blank emulsion five minutes before propofol, and patients of group K were administered mixed solution of ketamine and propofol. HR, BP, side effect,and pain of VAS score after artifical abortion were recorded. Reslts： Pain of VAS score after artifical abortion in group C and group K were higer than those of group F50 and group F75 at the same time（P〈0.05）, pain of VAS score after artifical abortion in group F50 and F75 began to decrease from 15 minutes after operation（P〈0.05）,while the pain of VAS score after artifical abortion in group C and group K began to decrease from 30 minutes afeter operation（P〈0.05）. Conclusion： Flurbiprofen axetil（50 mg and 75 mg） can reduce pain of VAS score after artifical abortion,and the possible mechanism maybe the flurbiprofen axetil inhibit the prostaglandin to release.