纳布啡联合异丙酚用于功能性子宫出血患者无痛宫腔镜检查术的临床效果

Efficacy of nalbuphine combined with propofol for painless hysteroscopy in patients with functional uterine bleeding

目的观察纳布啡注射液联合异丙酚用于功能性子宫出血患者无痛宫腔镜检査术的临床效果。方法选择2017年7月至12月天津市北辰区妇女儿童保健和计划生育中心门诊因功能性子宫出血拟行无痛宫腔镜检杳术患者120例,年龄28~45岁,ASA分级I或II级,采用随机双肓法分为异丙酚组和联合用药组,每组60例界丙酚组单纯静脉注射异丙酚,联合用药组加用盐酸纳布啡,两组患者均在睫毛反射消失、呼之无应答后开始手术观察两组患者在入室时、睫毛反射消失时、扩张宫颈时、意识恢复时平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO2)的变化;并记录术后苏醒时间、术中异丙酚用药量和苏醒期宫缩痛VAS评分。结果与入室时比较,睫毛反射消失时、扩张宫颈时、意识恢复时两组血液动力学参数均下降(P<0.05);与联合用药组比较,异丙酚组睫毛反射消失时、扩张宫颈时血液动力学参数下降更明显(P<0.05)。异丙酚组术中异丙酚的总用药量多于联合组(163±12比128±11),苏醒期宫缩痛VAS评分高于联合组(2.1 ±0.8比0.8±0.1 ,/J<0.05)。结论纳布啡联合异丙酚用于功能性子宫出血患者无痛宫腔镜检查术镇痛效果显著,血液动力学平稳,不良反应少.

Objective To observe the efficacy of nalbuphine combined with propofol for painless hysteroscopy in patients with functional uterine bleeding. Methods One hundred and twenty outpatients with functional uterine bleeding, aged 28-45 years old. underwent ptiinless hysteroscopy from July to December 2017 in Tianjin Beichen Women and Children Health and Family Planning Center, ASA I or II , were divided into propofol group and combined drug group with double-blind method randomly, sixty cases in each group. Only propofol was used in propofol group, and nalbuphine conibined with propofol was used in combined drug group. Painless hysteroscopy was performed after the eyelash reflex disappeared and no call-response. The changes of MAP. HR and SpO2 were observed at the time of entering the operation room, eyelash reflex disappearance, cervical dilatation and consciousness recovery. Poslopeiative consciousness recovery lime, intraoperative propofol dosage and VAS were recorded. Results Com pared with the time of entering the operation room, the hemodynamic parameters decreased at the time of eyelash reflex disappearance, cervical dilatation and consciousness recovery in the two groups (P<0.05). The hemodynamic parameters decreased more obviously in propofol group as compared with combined drug group (P<0.05). The total dose of propofol and VAS were higher in propofol group than those in combined drug group (163± 12 vs. 128± 1 1. 2.1 ±0.8 vs.0.8 ±0.1. P<0.05). Conclusion The analgesic effect of nalbuphine combined with propofol for painless hysteroscopy in patients with functional uterine bleeding is significant, with stable hemodynamics and fewer adverse reactions as compared with only propofol.