静脉麻醉下的人工流产对术后恢复及避孕的影响

Clinical Observation of Induced Abortion with Intravenous Anesthesia and Usual Abortion

目的:探究静脉麻醉下的无痛人工流产是否影响手术后恢复及术后避孕方法的选择。方法:本研究采用多中心临床调查,对本市计划生育学组10个成员单位的人工流产妇女进行随机抽样调查,并进行术后的随访,每个成员单位随机征集选取无痛人工流产(研究组)和普通人工流产(对照组)对象各100名。主要调查指标包括流产人群的一般情况、对人工流产危害的认识、术中和术后疼痛、术后阴道流血和转经情况、术后子宫内膜的恢复情况及术后避孕方法的选择。结果:共完成调查1782例,其中研究组947例,对照组835例。研究组对象年龄较轻,学历较高,所有对象均存在对人工流产危害的认识不足;研究组术后阴道出血时间5.5±3.5 d,转经时间34.5±8.0 d,与对照组相似(5.3±3.5 d,34.9±7.5 d,P>0.05)。术后3周子宫内膜厚度研究组为7.1±2.5 mm,对照组为6.8±2.6 mm,组间比较差异无统计学意义(P>0.05);对象术后避孕措施的选择组间也相似。结论:静脉麻醉下的人工流产对象术中处于安静状态,减少了疼痛和恐惧,与普通人工流产组相比,不增加术后对子宫内膜的过度损伤,不影响术后恢复和流产后避孕方法的选择。

Objective： To investigate the influence of surgical abortion with or without anesthesia to recovery and contraception. Methods： The multicenter investigation was carded out in 10 hospitals. Women who received surgical abortion with or without anesthesia were recruited in every hospital, 100 women in each group. The general characteristics, the awareness of the harm of abortion, the degree of pain during and post operation, post abortion bleeding, menstrual recovery, the thickness of endometrium in three weeks post abortion, and the contraception after abortion were concerned. Results： A total of 1 782 women who underwent surgical abortion were involved in the study, 947 women with anesthesia were set as study group and 835 women without anesthesia were set as control group. Although women were younger and more educated in study group, the awareness of the harm of abortion was rather poor in all the subjects. The duration of post abortion bleeding was 5.5 ± 3.5 d and menstrual recovery was 34.5 ± 8.0 d in study group, which were similar to the control （5.3 ± 3.5 d and 34.9 ± 7.5 d, respectively）. The endometrium thickness in three weeks post abortion was 7.1 ± 2.5 mm in study group and 6.8± 2.6 mm in the control （P〉0.05）. The contraceptive methods used post abortion were also similar in the two groups. Conclusion： Women were calm and painless during the surgical abortion with anesthesia. There were no more sign of endometrium over curettage and no more influence to post abortion recovery and contraception in study group compare with the control.