丙泊酚伍用氯胺酮及力月西在无痛人流中应用.doc

丙泊酚伍用氯胺酮及力月西在无痛人流中应用[摘要] 目的 探讨丙泊酚伍用氯胺酮与力月西复合麻醉应用于无痛人流的临床效果。方法 选择自愿要求无痛人流的产妇60例,随机分为A、B、C三组:A组(丙泊酚),B组(丙泊酚复合芬太尼)，C组：(丙泊酚复合氯胺酮与力月西)，每组20例。检测BP(血压)、HR(心率)、SpO2(血氧饱和度)、定向力恢复时间、术中出血量、宫颈扩张程度。结果 A、B组术中麻醉检测指标BP、HR波动与C组比较有统计学意义(P＜0.05)。A、B两组差异无统计学意义(P＞0.05),镇痛效果B、C两组明显优于A组(P＜0.05)，B、C两组差异无统计学意义(P＞0.05),孕妇术中出血量、宫颈扩张程度、定向力恢复时间，三组间比较无统计学意义(P＞0.05)。结论 丙泊酚伍用氯胺酮与力月西的全麻用药方法，能够安全有效的应用于无痛人流，对初次受孕,精神紧张,不易扩宫的孕妇尤为适用。 [关键词] 丙泊酚； 氯胺酮； 力月西； 芬太尼； 无痛人流 [中图分类号] R714.21 [文献标识码] B [文章编号] 1005-0515（2012）-01-029-01 Application of Propofol Associate with Ketamine and Midazolam in Anodynia Surgical Abortion Xian Jiqin Sun Chao (The Hospital of Women and Children of Zaozhuang,Shandong Shandong,Zaozhuang,277100,China) [Abstract] Objective To approach the clinical effect of propofol ketamine and midazolam combined anesthesia utendus anodynia surgical abortion. Methods Sixty lying-in women were randomly choose to divided into A,B,C groups,voluntary to request anodynia surgical abortion:A group(propofol),B group (propofol combined fentanyl),C group(propofol combined ketamine and midazolam),20 example each group. Bp HR Spo2 orientaion force recover time Volume of bleed in the operation Cervical dilatation level. Results BP and HR fluctuation of anesthesia detaction index in the A B groups contrasted C were statistical significance(P0.05).Analgesia Effect of B C group were surpassed obviously A group (p0.05).Three group comparison of orientaion force recover time Volume of bleed in the operation Cervical dilatation level were not statistical significance(P0.05).Conclusion General anaeshesia approach of propofol associate with ketamine and midazolam was utilized validly to anodynia surgical abortion and to pregnant women of for the first time conceiving mental strain Cervical dilatation was not easy was applicable especially. [Key words] Propofol; Ketamine; Midazolam; Fentanyl; Anodynia surgical abortion 人工流产术是避孕失败的补救措施之一，为终止妊娠的常用方法，但因手术中扩张宫颈及吸刮宫腔组织物时疼痛明显让很多患者难以接受，对孕妇的生理和心里都是一种严重的创伤