卡前列甲酯栓分别复合丙泊酚、笑气、利多卡因用于人工流产效果观察

Observation on the Effect of Carboprost Combined with Propofol,Nitrous Oxide or Lidocaine in Artificial Abortion

目的探讨人工流产术前阴道内放置卡前列甲酯栓分别复合丙泊酚、笑气、利多卡因终止早孕的临床效果。方法将1 250例要求中止妊娠的孕妇随机分成3组。丙泊酚组:采用丙泊酚+芬太尼行人工流产术462例(观察组240例和对照组222例);笑气组:采用笑气吸入行人工流产术408例(观察组208例和对照组200例);利多卡因组:采用0.5%利多卡因宫颈注射行人工流产术380例(观察组200例和对照组180例)。3组中的观察组均在术前1 h将卡前列甲酯栓0.5 mg放入阴道,对照组阴道内未置药。观察患者宫颈松弛情况、术中出血量、手术时间、术后阴道流血天数、镇痛效果。结果3组中,用卡前列甲酯栓后宫颈松弛度、术中出血量、手术时间、术后阴道流血天数等观察组与对照组比较,差别有统计学意义(P<0.05),而丙泊酚和笑气、利多卡因组间镇痛效果比较差别无统计学意义。结论卡前列甲酯栓能明显扩张宫颈,增强子宫收缩,使术中出血少、手术时间及术后阴道流血时间短。

Objective To approach different clinic effects of carboprost methylate combined with propofol, N2O, lidocaine respectively in terminating early pregnant. Method 1 250 patients asked for artificial abortion due to unexpected pregnancy were divided to 3 groups randomly. Propofol group： 462 cases by propofol and fentany, including 240 cases in observed group and 222 in controlled group ; N2O group： 408 eases, including 208 cases in observed group by inhalling N2O, and Z00 in controlled group; lidocaine group： 380 cases , including 200 cases in observed group by 0. 5% lidoeaine cervical injection and 180 in controlled group. All patients in these 3 observed groups were put carboprost methylate 0. 5 mg into the vagina I hour before abortion, but not in the control groups, and then observed the situation of cervical dilation , blood losing during the operation, days of vaginal bleeding after operation and the analgesia effect. Results The observed groups compared to control groups in these three groups, the situation of cervical dilation , blood losing during the operation, days of vaginal bleeding after operation with significant difference （P〈0.05）. Which was due to using carboprost methylate. The analgesia effect. during abortion without significant difference between three groups. Conclusion That using propofol, N2O, lidocaine for analgesia combining with carboprost methylate vaginal putting could dilate cervix obviously, and promote the contraction of uterus, so that reducing blood loosing during operation , shorten the operation time and days of vaginal bleeding after operation.