CAJ | 학술논문

　　目的：观察丙泊酚芬太尼复合液伍用少量麻黄碱用于人工流产的麻醉效果,探讨此类手术合理的静脉药物配方。方法：选择我院2008年1月~2013年1月门诊收治入院的200例自愿终止妊娠的ASAⅠ~Ⅱ级早孕妇女,随机分为两组,每组100例,分别于术前缓慢静注芬太尼2μg/kg 3分钟后,A组丙泊酚2mg/kg,B组丙泊酚2mg/kg＋麻黄碱0.08mg/kg诱导,于40~60秒内注完,意识消失后开始手术,观察术中视患者反应情况及连续检测SBP、DBP、HR、SpO2的变化,并观察患者手术的麻醉起效时间、手术时间、出血量、宫腔深度、术后恢复时间、麻醉镇痛效果及不良反应情况。结果：两组患者的麻醉起效时间、手术时间、出血量、宫腔深度、术后恢复时间相比,均差异无显著性(P>0.05)；A、B组诱导后SBP、DBP明显下降,HR减慢,与麻醉前比较差异有统计学意义(P<0.05)；A组SBP、DBP在麻醉后3min、5min、10min后明显下降,与B组比较差异有统计学意义(P<0.05)；A、B两组术中麻醉镇痛效果及术后恢复时间无显著性差异(P>0.05)。B组丙泊酚用量为(92±32)mg。A组丙泊酚用量为(166±67)mg,显然,B组比A组丙泊酚用量少(P<0.05)。与A组比较,B组的不良反应(肢体活动、呼吸暂停)差异有统计学意义(P<0.05)。结论：丙泊酚芬太尼复合液伍用少量麻黄碱用于门诊无痛人工流产手术是一种非常安全和有效配伍方法,值得推广。
　　목적：관찰병박분분태니복합액오용소량마황감용우인공유산적마취효과,탐토차류수술합리적정맥약물배방。방법：선택아원2008년1월~2013년1월문진수치입원적200례자원종지임신적ASAⅠ~Ⅱ급조잉부녀,수궤분위량조,매조100례,분별우술전완만정주분태니2μg/kg 3분종후,A조병박분2mg/kg,B조병박분2mg/kg＋마황감0.08mg/kg유도,우40~60초내주완,의식소실후개시수술,관찰술중시환자반응정황급련속검측SBP、DBP、HR、SpO2적변화,병관찰환자수술적마취기효시간、수술시간、출혈량、궁강심도、술후회복시간、마취진통효과급불량반응정황。결과：량조환자적마취기효시간、수술시간、출혈량、궁강심도、술후회복시간상비,균차이무현저성(P>0.05)；A、B조유도후SBP、DBP명현하강,HR감만,여마취전비교차이유통계학의의(P<0.05)；A조SBP、DBP재마취후3min、5min、10min후명현하강,여B조비교차이유통계학의의(P<0.05)；A、B량조술중마취진통효과급술후회복시간무현저성차이(P>0.05)。B조병박분용량위(92±32)mg。A조병박분용량위(166±67)mg,현연,B조비A조병박분용량소(P<0.05)。여A조비교,B조적불량반응(지체활동、호흡잠정)차이유통계학의의(P<0.05)。결론：병박분분태니복합액오용소량마황감용우문진무통인공유산수술시일충비상안전화유효배오방법,치득추엄。
Objective:Propofol fentanyl combined with a small amount of liquid ephedrine used for anesthesia in artificial abortion,intravenous drug formulation of this kind of operation is reasonable.Methods:In our hospital in 2008 January ~2013 year in January outpatients from 200 cases of voluntary termination of pregnancy of ASA Ⅰ~Ⅱ pregnant women,were randomly divided into two groups,100 cases in each group, respectively before the slow intravenous injection of fentanyl 2μg/kg 3 minutes later,groupA propofol 2mg/kg,B group of propofol 2 mg/kg+0.08 ephedrine the induction of mg/kg,from 40 to 60 seconds after injection,lost consciousness after the start of operation,changes in the reaction of patient observation and continuous detection of SBP,DBP,HR,SpO2,onset time,operation time,amount of bleeding,uterine cavity depth,postoperative recovery time,analgesic effect and the adverse reaction of anesthesia and anesthesia.Observation of the patients with operation.Results:The recovery time of onset time,operation time,amount of bleeding,uterine cavity depth,postoperative anesthesia in the patients of the two groups were compared no significant difference (P>0.05);A,B group,DBP decreased significantly after induction of SBP,HR decreased, compared with before anesthesia,the difference was statistically significant (P<0.05);A group SBP,DBP in 3min,5min,10min after anesthesia was significantly decreased compared with B group,the difference was statistically significant (P<0.05);A,B anesthesia analgesia and postoperative recovery time after operation in two groups had no significant difference (P>0.05).Group B propofol dosage was (92±32)mg.GroupA propofol dosage was (166±67)mg,obviously in group B than in groupA propofol consumption (P<0.05).Compared with group A,the adverse effects of B group (physical activity,apnea) the difference was statistically significant (P<0.05).Conclusion:Propofol and fentanyl combined with a small amount of liquid ephedrine for outpatient painless operation is a safe and effective method of compatibility,worthy of promotion.