米索前列醇联合利多卡因用于人流术的效果评价

Evaluation of misoprostol combined with lidocaine in artificial abortion

目的探讨米索前列醇联合2％利多卡因应用于人工流产术的临床价值。方法将孕6～10周要求终止妊娠的孕妇300例随机分为3组行负压吸引术。A组：术前1—2小时阴道后穹窿放置米索前列醇200μg，联合术中宫颈注射2％利多卡因及宫腔灌注2％利多卡因；B组：术中使用宫颈注射2％利多卡因及宫腔灌注2％利多卡因；C组：行传统负压吸引术。观察3组患者术中宫颈扩张程度、镇痛效果、人工流产综合征的发生率、术中出血量、手术时间。结果A组、B组镇痛效果及扩宫效果明显优于C组，经比较差异均有统计学意义（X^2值分别为103．654、109．166，均P〈0．05）。B组、C组出血量均高于A组，经比较差异均有统计学意义（t值分别为27．847、6．391，均P〈0．05），C组术中平均出血量高于B组，两组比较差异有统计学意义（t=7．072，P〈0．05）。A组、B组人工流产综合征发生率低于C组，其中恶心、脉缓、血压下降3组比较差异均有统计学意义（X^2值分别为13．315、16．579、18．741，均P〈0．05）。结论米索前列醇联合宫颈注射及宫腔灌注利多卡因应用于负压吸引人流术具有操作简单、方便、安全、有效和副反应少等优点。

Objective To explore the clinical value of misoprostol combined with 2% lidocaine in artificial abortion. Methods Totally 300 cases of pregnant women at 6-10 weeks of termination of pregnancy were randomly divided into three groups for vacuum aspiration. For group A preoperative 1-2h misoprostol 200p.g was placed at vaginal fornix, combined with intraoperative cervical injection of 2% lidoeaine and uterine infusion of it. Cervical injection and uterine infusion of 2% lidocaine were for group B during operation. Group C underwent traditional vacuum aspiration. Three groups were observed in the aspects of the degree of cervical dilatation, analgesic effect, the incidence of artificial abortion syndrome, intraoperative bleeding volume and operation time. Results The analgesic effect and dilation effect of group A and B were significantly higher than those of group C, and the differences were significant （X^2 value was 103. 654 and 109. 166, respectively, both P 〈 0.05 ）. The bleeding amount of group B and C was more than that of group A （ t value was 27. 847 and 6. 391, respectively, both P 〈 0.05）. Compared with group B, the average intraoperative blood loss in group C was more （t = 7. 072 ,P 〈 0.05 ）. The incidence of artificial abortion syndrome in group A and B was lower than group C, and there were significant differences in the incidence of nausea, slow pause and blood pressure decrease among three groups （X^2 value was 13. 315, 16. 579 and 18. 741, respectively, all P 〈 0. 05 ）. Conclusion Misoprostol combined with cervical injection and uterine infusion of lidocaine in vacuum aspiration abortion has the advantages of simple practice, convenience, safety, effectiveness and less side reaction.