人工流产中3种用药方法的扩宫镇痛效果

Effect of Three Kinds of Application Methods on Cervical Dilatation for Induced Abortion

目的:探讨人工流产扩宫镇痛的理想用药方法。方法:300例妊娠早期妇女随机分为3组。利多卡因组(A组)暴露宫颈,在宫颈3,9点处注射利多卡因各1mL,1min后开始行人工流产术;米索前列醇(以下称米索)组(B组)术前2h直肠放置米索400μg;米索联合利多卡因组(C组)直肠放置米索400μg,2h后在宫颈3,9点处注射利多卡因各1mL,1min后开始行人工流产术。观察3组患者宫颈扩张情况、镇痛效果、并发症、人工流产综合征发生率及出血量。结果:C组镇痛效果明显优于A和B组(P<0.01),且手术时间短。C组宫颈扩张程度优于A组(P<0.01),与B组差异无统计学意义(P>0.05)。术中出血量差异无统计学意义(P>0.05)。A组1例发生人工流产综合征,B和C组无发生。结论:直肠放置米索400μg联合利多卡因用于人工流产可达到扩宫镇痛的良好效果,用药简单、有效、安全,可推广使用。

Objective：To explore the ideal method on cervical dilatation for induced abortion. Methods： 300 cases of early pregnant women were randomly divided into 3 groups. Patients in group A （lidocaine group） exposed the cervix who were injected by 1 mL lidocaine at the 3 and 9 point of the cervix, and abortion operation started after 1 minute. Patients in group B （misoprostol group） were placed 400 μg mlsoprostol in the rectum 2 hours beforeoperation. Patients in group C （misoprostol combined with lidocaine group） were placed 400 μg misoprostol in the rectum and injected by 1 mL lidocaine at the 3 and 9 point of the cervix 2 hours later, and operation started after I minute. Cervical dilatation,analgesia,complications, incidence of abortion syndrome and bleeding were observed in the three groups. Results： The analgesia effect of group C was obviously better than that of group A and group B （P〈0.01）, and the operation time was shorter. The cervical dilation of group C was better than that of group A （P〈0.01）, but there was no siglificant difference from group B （P〉0.05）. There was no obvious difference among the blood loss of the three groups （P〈0.05）. No abortion syndrome happened in groups B and C, while there was 1 case of abcrtion syndrome in group A. Conclusions： Rectal administration of 400 μg misoprostol combined with lidocaine analgesia for induced abortion can achieve good results of cervical dilatation. Medication is simple, effective, safe and can be widely used.