中国当代医药
中國噹代醫藥
중국당대의약
PERSON
2015年
11期
110-112,115
,共4页
B超引导%高危无痛人工流产%异丙酚%氯胺酮%瑞芬太尼%舒芬太尼%利多卡因
B超引導%高危無痛人工流產%異丙酚%氯胺酮%瑞芬太尼%舒芬太尼%利多卡因
B초인도%고위무통인공유산%이병분%록알동%서분태니%서분태니%리다잡인
B ultrasound guide%High risk painless in-duced abortion%Propofol%Ketamine%Remifentanil%Sufen-tanil%Lidocaine
目的：观察异丙酚复合舒芬太尼、利多卡因在B超引导下高危无痛人工流产术麻醉中的应用效果。方法选择本院2013年1月~2014年10月拟行B超引导下无痛人工流产术的高危早孕患者120例，随机分成3组，每组40例。 A组：异丙酚复合氯胺酮组；B组：异丙酚复合瑞芬太尼、利多卡因组；C组：异丙酚复合舒芬太尼、利多卡因组。记录给药前后各时间点的MAP、HR、SpO2以及术中异丙酚用量、苏醒时间、清醒时间及不良反应[精神症状、呼吸抑制(一过性)、肢体活动、术后宫缩痛、恶心呕吐、异丙酚注射痛]发生情况。结果 A、B、C组均镇痛满意，异丙酚注射痛发生率低。3组患者麻醉后的MAP、HR均下降，与麻醉诱导前比较，差异有统计学意义(P<0.05)，但B、C组较A组下降明显(P<0.05)， B组麻醉后的SpO2降低较A、C组明显(P<0.05)。 A组的异丙酚用量少于B、C组，苏醒时间、清醒时间长于B、C组(P<0.05)。 A组的精神症状、肢体活动、恶心呕吐发生率明显高于B、C组(P<0.05)；B组的呼吸抑制(一过性)、术后宫缩痛发生率高于A、C组(P<0.05)。结论异丙酚复合舒芬太尼、利多卡因用于B超引导下高危无痛人工流产术，是一种更为理想的麻醉方法。
目的：觀察異丙酚複閤舒芬太尼、利多卡因在B超引導下高危無痛人工流產術痳醉中的應用效果。方法選擇本院2013年1月~2014年10月擬行B超引導下無痛人工流產術的高危早孕患者120例，隨機分成3組，每組40例。 A組：異丙酚複閤氯胺酮組；B組：異丙酚複閤瑞芬太尼、利多卡因組；C組：異丙酚複閤舒芬太尼、利多卡因組。記錄給藥前後各時間點的MAP、HR、SpO2以及術中異丙酚用量、囌醒時間、清醒時間及不良反應[精神癥狀、呼吸抑製(一過性)、肢體活動、術後宮縮痛、噁心嘔吐、異丙酚註射痛]髮生情況。結果 A、B、C組均鎮痛滿意，異丙酚註射痛髮生率低。3組患者痳醉後的MAP、HR均下降，與痳醉誘導前比較，差異有統計學意義(P<0.05)，但B、C組較A組下降明顯(P<0.05)， B組痳醉後的SpO2降低較A、C組明顯(P<0.05)。 A組的異丙酚用量少于B、C組，囌醒時間、清醒時間長于B、C組(P<0.05)。 A組的精神癥狀、肢體活動、噁心嘔吐髮生率明顯高于B、C組(P<0.05)；B組的呼吸抑製(一過性)、術後宮縮痛髮生率高于A、C組(P<0.05)。結論異丙酚複閤舒芬太尼、利多卡因用于B超引導下高危無痛人工流產術，是一種更為理想的痳醉方法。
목적：관찰이병분복합서분태니、리다잡인재B초인도하고위무통인공유산술마취중적응용효과。방법선택본원2013년1월~2014년10월의행B초인도하무통인공유산술적고위조잉환자120례，수궤분성3조，매조40례。 A조：이병분복합록알동조；B조：이병분복합서분태니、리다잡인조；C조：이병분복합서분태니、리다잡인조。기록급약전후각시간점적MAP、HR、SpO2이급술중이병분용량、소성시간、청성시간급불량반응[정신증상、호흡억제(일과성)、지체활동、술후궁축통、악심구토、이병분주사통]발생정황。결과 A、B、C조균진통만의，이병분주사통발생솔저。3조환자마취후적MAP、HR균하강，여마취유도전비교，차이유통계학의의(P<0.05)，단B、C조교A조하강명현(P<0.05)， B조마취후적SpO2강저교A、C조명현(P<0.05)。 A조적이병분용량소우B、C조，소성시간、청성시간장우B、C조(P<0.05)。 A조적정신증상、지체활동、악심구토발생솔명현고우B、C조(P<0.05)；B조적호흡억제(일과성)、술후궁축통발생솔고우A、C조(P<0.05)。결론이병분복합서분태니、리다잡인용우B초인도하고위무통인공유산술，시일충경위이상적마취방법。
Objective To observe the application effect of propofol combined with sufentanil, lidocaine used in anes-thesia of high risk painless induced abortion under B ultrasound guide. Methods 120 high risk patients with early pregnancy scheduled for painless induced abortion under B ultrasound guide from January 2013 to October 2014 in our hospital were selected and they were randomly divided into three groups,and there were 40 cases in each group. Group A:propofol combined with ketamine group,group B:propofol combined with remifentanil,lidocaine group;group C:propofol combined with sufentanil,lidocaine group.MAP,HR,SpO2 of different time points before and after drug adminis-tration and intraoperative propofol dosage,recovery time,awake time and the incidence of adverse reaction [psychiatric symptoms,respiratory depression (temple),physical activity,uterine contraction pain,nausea and vomiting,the incidence of pain on injection of propofol] were recorded. Results Analgesia of three groups was satisfactory,and incidence rate of injection pain for propofol was low.After anesthesia,MAP,HR were decreased of three groups and there was a statistical difference compared with before anesthesia induction (P<0.05),but MAP,HR were decreased obviously in group A and B (P<0.05),and SpO2 after anesthesia of group B was obviously decreased compared with group A and C (P<0.05).The dosage of propofol of group A was fewer than that of group B and C,and the recovery time, awake time of group A was longer than that of group B and C (P<0.05).The incidence rate of psychiatric symptom, physical activity, nausea and vomiting was significantly higher than those of group B and C (P<0.05);the incidence rate of respiratory depression (temple),uterine contraction pain was higher than that of group A and C (P<0.05). Conclusion Propofol combined with sufentanil, lidocaine for high risk painless induced abortion under B ultrasound guide is a more ideal anesthesia method.
