杜冷丁联合安定应用于人工流产术的临床研究

Clinical study of the analgesic effect and security of the combined application of dolantin with diazepam to induced abortion

目的：探讨杜冷丁联合安定应用于人工流产术的安全性和有效性.方法：将150例早孕患者随机分为3组,每组50例.所有患者均于术前阴道放置米索前列醇片400 μg,工组：在全麻下（芬太尼联合异丙酚）行人工流产术;Ⅱ组：肌肉注射杜冷丁联合静脉注射安定行人工流产术;Ⅲ组（对照组）不予任何药物,仅口头安慰患者后行人工流产术.记录3组患者的镇痛效果、手术操作时间、6号扩条通过率、不良反应发生率,术前（T0）、扩张宫颈（T1）时、吸刮宫腔（T2）时、手术结束（Tt）时的HR、MAP、SpO2和RR.结果：与Ⅲ组比较,Ⅰ、Ⅱ组手术时间短和6号扩条通过率高,术后满意度评分和口述镇痛评分高（P＜0.05）,Ⅰ、Ⅱ组在T1～T3的HR、MAP和RR均低于Ⅲ组（P＜0.05）;与Ⅲ组比较,Ⅰ、Ⅱ组人流综合征发生率低（P＜0.05）,工组腹肌僵硬、舌根后坠的发生率较高.结论：杜冷丁联合安定的镇痛效果确切,不良反应少,是一种安全、有效的人工流产术的镇痛方法.

Objective：To investigate the analgesic effect and security of the combined application of dolantin with diazepam to the artificial termination of pregnancy. Methods. 150 cases of early pregnancy were randomized into 3 groups with 50 cases in each group： Group A, B and C. All patients were placed 400 μg of misoprostol tablets into the vagina before operations. Group A were performed artificial abortion operation under intravenous anesthesia by fentanyl combined with propofol Group B were applied dolalntin combined with diazepam to the artificial termination of pregnan time, success rate of cervical dilatation, and adverse reaction rate of the three groups were record -ed. Also the HR, MAP, SpO2 and RR before operation （T0）, at cervical dilatation （T1）, and suction and scraping the uterine cavities （T2） were recorded. Results： 1. Compared with patients in Group C, patients in Group A and B needed shorter operation time and had high success rate of cervical dilatation, and high postoperative satisfaction score and oral analgesic score （P〈0.05）; 2. HR, MAP and RR of Group A and B at between T1 and T2 were lower than those in Group C; 3. Compared with Group C, the incidence of abortion syndrome of Group A and B was lower （P〈0. 05）. And the incidence rate of abdominal muscle stiffness and glossocoma in Group A was higher. Conclusion： Dolantin combined with diazepam shows an excellent analgesic effect and less adverse reactions in induced abortion. So it is a kind of safe and effective analgesic method in induced abortion.