CAJ | 학술논문

目的：对比研究丙泊酚单用及配伍芬太尼、氯胺酮、地佐辛在人工流产术中的镇痛效果及安全性。方法：将160例患者随机分为A、B、C、D四组，每组40例，A组患者单纯使用丙泊酚进行麻醉；B组患者使用丙泊酚配伍芬太尼进行麻醉；C组患者使用丙泊酚配伍氯胺酮进行麻醉；D组患者使用丙泊酚配伍地佐辛进行麻醉。观察并记录各组患者丙泊酚的总用量、唤醒时间、定向力恢复时间，以及患者呼吸抑制和体动反应发生情况，术中镇痛效果和术后下腹痛VAS评分。结果：唤醒时间和定向力恢复时间A组明显长于B、C、D组（P＜0.05）；术中镇痛效果B、C、D组明显优于A组，术后下腹痛VAS评分，D组明显优于其它各组（P＜0.05）。在安全性方面，A组患者术中体动明显多于B、C、D组，而B、C组的呼吸抑制发生率明显高于A、D组（P＜0.05）。结论：丙泊酚配伍地佐辛用于无痛人工流产，镇痛效果强，呼吸抑制率低，安全有效，值得临床广泛使用。
목적：대비연구병박분단용급배오분태니、록알동、지좌신재인공유산술중적진통효과급안전성。방법：장160례환자수궤분위A、B、C、D사조，매조40례，A조환자단순사용병박분진행마취；B조환자사용병박분배오분태니진행마취；C조환자사용병박분배오록알동진행마취；D조환자사용병박분배오지좌신진행마취。관찰병기록각조환자병박분적총용량、환성시간、정향력회복시간，이급환자호흡억제화체동반응발생정황，술중진통효과화술후하복통VAS평분。결과：환성시간화정향력회복시간A조명현장우B、C、D조（P＜0.05）；술중진통효과B、C、D조명현우우A조，술후하복통VAS평분，D조명현우우기타각조（P＜0.05）。재안전성방면，A조환자술중체동명현다우B、C、D조，이B、C조적호흡억제발생솔명현고우A、D조（P＜0.05）。결론：병박분배오지좌신용우무통인공유산，진통효과강，호흡억제솔저，안전유효，치득림상엄범사용。
Objectives:To compare the effect and safety of propofol alone and joint use with fentanyl,ket-amine,and dezocine in artificial abortion.Methods:160 patients were randomly divided into group A,B,C,D, 40 cases in each group.Group A,B,C and D adopted propofol,propofol combined with fentanyl,propofol com-bined with ketamine and propofol combined with dezocine for anesthesia respectively.Total amount of propofol, wake-up time,orientation recovery time,and the respiratory depression and body dynamic response of each group were observed and recorded.Intraoperative analgesic effect and postoperative lower abdominal pain VAS were graded in each group.Results:As to wake-up time and orientation,recovery time,group A was significantly longer than group B,C,D (P<0.05);intraoperative analgesia effect of group B,C,D were obviously better than group A;postoperative lower abdominal pain VAS score of group D was better than the other groups (P<0.05).In terms of safety,body dynamic response of group A was significantly more than group B,C,D,while the incidence of respir-atory depression in group B,C was significantly higher than group A,D (P<0.05).Conclusions:For induced a-bortion,propofol combined with dezocine has strong analgesic effect with low respiratory depression.As a safe and effective method,it is worthy wide application in clinical practice.