安定联合杜冷丁配伍米索前列醇片应用在塞阴无痛人流术中的效果分析

Analysis on the use of diazepam combined with pethidine misoprostol tablets in painless induced abortion

目的:探究安定联合杜冷丁配伍米索前列醇片塞阴无痛人流术的运用。方法:对我院2009年10月至2011年10月收治的52例自愿流产孕妇进行无痛人流术,在签署知情同意书后将其分为观察组(n=26)和对照组(n=26),前者接受安定联合杜冷丁配伍米索前列醇片进行塞阴镇痛,后者仅接受安定联合杜冷丁进行镇痛,对比两组孕妇手术情况、镇痛效果、宫颈软化程度及人流综合征(RAAS)出现情况。结果:观察组镇痛显效25例,有效1例,总有效率100.0%;对照组镇痛显效4例,有效9例,总有效率50.0%;观察组镇痛总有效率明显高于对照组。观察组术中宫颈软化度显效21例,有效5例,总有效率100.0%;对照组显效6例,有效18例,总有效率92.3%;两组孕妇总有效率无明显统计学差异(P>0.05),观察组显效率明显高于对照组。观察组术中未见RAAS并发症,对照组术中出现12例RAAS并发症,并发症发生率46.2%,观察组RAAS出现率明显低于对照组(χ2=5.743,P<0.05)。观察组术中失血量(10.6±1.9)mL,对照组为(14.3±2.5)mL,观察组术中失血量明显低于对照组(t=8.039,P<0.05)。结论:安定联合杜冷丁能够明显软化孕妇宫颈,降低手术流产难度,而配伍米索前列醇片塞阴无痛人流术能够抵抗麻醉药物肌松作用,收缩子宫,降低术中疼痛及出血量,是一种安全、高效、理想的联合用药方法,值得临床广泛推广。

Objectives： To explore the use of diazepam combined with pethidine misoprostol tablets in painless induced a bertion. Method： 52 pregnant women of voluntary abortion presenting in our hospital from October 2009 to October 2011 were se lected. After signing the informed consent, they were divided into the observation group （ n = 26） and the control group （ n = 26）. Patients in the observation group were ministered diazepam combined with pethidine misoprostol tablets, while the patients in the control group only received diazepam combined with pethidine. The analgesic effect of the operation condition, the degree of cervical softening and abortion syndrome （RAAS） were compared. Results： In the observation group, 26 cases showed excel lent analgesic effect, and one showed effective effect, with the total efficiency of 100%. In the control group, there were 4 cases showing excellent analgesic effect, with 9 effective cases, and the total efficiency reached 50%, which was obviously lower than that of the observation group. In the observation Sroup, there were 21 excellent cases with cervical softening and 5 effective cases, with 100% total efficiency. In the control group, there were 6 excellent cases and 18 effective cases, with the total efficiency 92. 3%, which was slightly lower than that of the observation group. The total efficiency of cervical softening of the two groups had no statistically significant difference （P 〉 0.05）. No case in the observation group showed complications of RAAS, while 12cases in the control group had RAAS complications during operation, with the complication rate 46.2%, Which was obviously higher than that of the observation group （X2 = 5. 743, P 〈 0.05 ） ; The hemorrhage volume were （ 10.6 ± 1.9 ） ml in the observa tion group and （ 14.3 ±2.5 ） ml in the control group, the hemorrhage volume in the observation group was lower （ t = 8. 039, P 〈 0.05）. Conclusion ： The use of diazepam combined with pethidine can significantly lower the cervical softening degree and re duce abortion operation difficulty in induced abortion. Misoprostol tablets plug Yin can resist the anesthetic muscle relaxation to contract the uterine and reduce intraoperative pain and bleeding, which is an ideal and safe combination method with high effi ciency to be applied in clinical treatment.