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目的:探讨利多卡因宫颈、宫内注射及米索前列醇用于人工流产镇痛的临床效果。方法:将符合要求并自愿接受人工流产术的妊娠6~10周妇女432例按就诊先后顺序以A、B、C、D循环分组:A组110例,单纯宫颈注射利多卡因;B组106例,宫颈注射利多卡因联合宫腔灌注;C组107例,术前1~2h阴道后穹窿放置米索前列醇200μg;D组109例为对照组,不采取任何镇痛措施,按常规操作手术。观察每组患者的镇痛有效率、宫颈松弛率及人工流产综合征等并发症发生率。结果:①3个镇痛组与对照组比较,镇痛、扩宫效果差异均有统计学意义(镇痛P<0.05,扩宫P<0.01)。②在缩短手术时间和减少出血量上,C组明显优于其他3组,差异有统计学意义(P<0.05);A组与B组较D组时间长,但差异无统计学意义(P>0.05)。③镇痛组人工流产综合征发生率明显低于对照组(P<0.05)。结论:3种镇痛方法均简单、安全、迅速、有效、易于掌握,尤其米索前列醇镇痛效果显著,适合于基层医院推广应用。
Objective: To investigate the clinical efficacy of lidocaine for cervical intrauterine injection and misoprostol for induced abortion. Methods: A total of 432 pregnant women of 6 to 10 weeks of gestation, who met the requirements and voluntarily accepted abortion, were divided into groups A, B, C and D according to the order of their visits: 110 cases in group A and only lidocaine injection in cervix; 106 cases in group B Case, cervical injection of lidocaine combined with intrauterine perfusion; Group C 107 cases, 1 ~ 2h preoperative vaginal posterior fornix 200μg; D group, 109 cases as control group, do not take any analgesic measures, according to conventional operation surgery. Observe the analgesic efficiency, cervical relaxation rate and the incidence of complications such as abortion syndrome in each group of patients. Results: ① There were significant differences in analgesia and dilation between the three analgesia groups and the control group (analgesia, P <0.05, dilation, P <0.01). ②Compared with the other three groups, the C group was significantly better than the other three groups in shortening the operation time and reducing the amount of bleeding (P <0.05); A and B groups were longer than the D group, but the difference was not statistically significant (P > 0.05). ③ The incidence of induced abortion syndrome was significantly lower in the analgesic group than in the control group (P <0.05). Conclusion: The three analgesic methods are simple, safe, rapid, effective and easy to grasp. Especially analgesic effect of misoprostol is significant and suitable for the popularization and application of primary hospitals.