4种不同药物配伍用于无痛人工流产术效果分析和评价

Retrospective Investigation of Clinical Application of Four Different Drugs Combination in Painless Induced Abortion

目的:探讨无痛人工流产术安全、有效、比较理想的药物配伍。方法:选择2003年1月—2010年1月在门诊实施人工流产术的816例患者作为研究对象,随机分为4组,分别采用4种不同药物配伍方法施行手术,回顾比较分析无痛人工流产手术效果并进行评价。其中A组(121例)应用氯胺酮50 mg+双氯酚酸钠栓50 mg,B组(247例)应用异丙酚[平均(121.7±21.2)mg]+双氯酚酸钠栓50 mg,C组(127例)应用异丙酚[平均(122.3±20.2)mg]+芬太尼0.05 mg,D组(321例)应用异丙酚[平均(115.9±19.8)mg]+氟比洛芬酯50mg。结果:①B、C和D组患者术中的肢体反应及术后的不良反应明显低于A组(P<0.01)。②C组和D组术中的镇痛效果明显优于B组(P<0.01)。③D组的苏醒时间及定向恢复时间少于C组(P<0.05)。④D组异丙酚用量少于B和C组(P<0.05)。结论:氟比洛芬酯与异丙酚配伍行无痛人工流产是目前最安全且临床最有效的药物配伍方案之一,在临床上具有良好的推广价值。

Objective： To evaluate the effectiveness and safety of the combined application of drugs in painless abortion. Methods：816 patients receiving painless abortion were classified randomly into four groups as follows,group A：ketamine 50 mg and diclofenac sodium suppositories 50 mg,group B：propofol and diclofenac sodium suppositories 50 mg,group C：propofol and fentanyl 0.05 mg,and group D：propofol and flurbiprofen axetil 50 mg. Results：（1）The body reactions of group B,C and D were superior to group A （P〈0.01）. （2）The analgesic effects of group C,D were superior to group B （P〈0.01）. （3）The recovery time and orientation time of group D were less than those of group C （P〈0.05）. （4）The dosage of propofol in group D was less than that of group B and C （P〈0.05）. Conclusions：Combination of propofol and flurbiprofen is one of the safest and effective way for painless induced abortion, which is worth in clinical practice.