盐酸纳布啡复合丙泊酚用于门诊人工流产术麻醉的疗效及安全性

doi:10.3969/j.issn.10073205.2018.11.020

摘要/Abstract

摘要： ［摘要］〓
〖HTH〗目的〖HTSS〗〖KG*2〗观察盐酸纳布啡复合丙泊酚用于门诊人工流产术的疗效、术后镇痛效果及安全性。
〖HTH〗方法〖HTSS〗〖KG*2〗选择ASAⅠ~Ⅱ级人工流产者120例，按随机数字表法分为对照组和试验组，每组60例。试验组静脉注射盐酸纳布啡0.2 mg/kg（稀释至2 mL）, 1 min后静脉注射丙泊酚2.0 mg/kg;对照组静脉注射生理盐水2 mL,1 min后静脉注射丙泊酚3.0 mg/kg。观察2组麻醉效果、术中丙泊酚用量、苏醒时间、术后5 min 和30 min子宫收缩疼痛评分以及不良反应，记录人工流产者入室时(T0)、睫毛反应消失时(T1)、手术开始时(T2)、手术结束时(T3)及术后5 min时(T4)的收缩压（systolic blood pressure，SBP）、舒张压（diastolic blood pressure，DBP）、心率（heart rate，HR）及脉搏血氧饱和度（pulse oxygen saturation,SpO2）。
〖HTH〗结果〖HTSS〗〖KG*2〗2组SBP、DBP呈先降低再高升的趋势，时点间差异有统计学意义（P＜005），组间、组间·时点间交互作用差异无统计学意义（P＞005）。2组HR呈先降低再高升的趋势，时点间、组间·时点间交互作用差异有统计学意义（P＜005），组间差异无统计学意义（P＞005）。2组SpO2呈逐步上升的趋势，时点间差异有统计学意义（P＜005），组间、组间·时点间交互作用差异无统计学意义（P＞005）。试验组术中丙泊酚用量少于对照组，苏醒时间短于对照组（P＜005）。试验组术后5 min和30 min子宫收缩疼痛评分显著低于对照组，满意度优于对照组（P＜005）。2组并发症发生率差异无统计学意义（P＞005）。
〖HTH〗结论〖HTSS〗〖KG*2〗盐酸纳布啡复合丙泊酚实施无痛人工流产术是一种安全有效的麻醉方法，可减少丙泊酚的用量，对术后子宫收缩疼痛有良好的镇痛效果，且未见明显不良反应。

关键词: 流产, 人工, 盐酸纳布啡, 丙泊酚

Abstract: ［Abstract］〓Objective〖HTSS〗〓To evaluate the efficacy, analgesic effect and the safety of nalbuphine combined with propofol in outpatient induced abortion.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓A total of 120 patients with ASA grade Ⅰ to Ⅱ induced abortion were randomly divided into control group and experimental group, 60 cases in each group. The experimental group was intravenously injected with 0.2 mg/kg nabuprofen hydrochloride(diluted to 2 mL), and intravenously injected with propofol 2.0 mg/kg one minute later. The control group received intravenous injection of 2 mL of normal saline as control, and 1 minutes after intravenous injection of propofol 3.0 mg/kg. The anesthesia effect, propofol dosage during operation, recovery time, uterine contractile pain score at 5 and 30 minutes after operation and adverse reactions were observed. Systolic blood pressure(SBP), diastolic blood pressure(DBP), heart rate(HR) and pulse oxygen saturation(SpO2) were recorded at T0(entering the room), T1(the eyelash reaction disappeared), T2(at the beginning of the operation), T3(at the end of the operation)and T4(5 minutes after the operation).
〖HTH〗〖WTHZ〗Results〖HTSS〗〓SBP and DBP in the two groups showed a trend of decreasing first and then increasing, the difference was statistically significant between the time points(P＜005). There was no significant difference in the interaction between groups and time points(P＞005), and there was no significant difference between the two groups(P＞005). HR of the two groups showed a trend of decreasing first and then increasing, and the interaction between groups and time points(P＜005) and between groups was statistically significant(P＜005), but there was no significant difference between the two groups(P＞005). SpO2 of the two groups showed a gradual upward trend, the difference was statistically significant between time points(P＜005), there were no significant difference in the interaction between groups and time points and between groups(P＞005). The dosage of propofol in the experimental group was less than that in the control group, and the recovery time was shorter than that in the control group(P＜0.05). The pain score of uterine contraction in the experimental group was significantly lower than that in the control group at 5 and 30 minutes after operation, and the satisfaction was better than that in the control group(P＜005). There was no significant difference in the incidence of complications between the 2 groups(P＞0.05).
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Hydrochloride nalbuphine combined with propofol is a safe and effective anesthesia method in artificial abortion. Hydrochloride nalbuphine markedly reduced the dosage of propofol, showed an outstand analgesic effect on postoperative uterine contraction pain without obvious adverse reactions.

Key words: abortion, induced； nalbuphine, propofol

程艳欣，常和平，张〓健，刘亚静，赵森明*. 盐酸纳布啡复合丙泊酚用于门诊人工流产术麻醉的疗效及安全性[J]. 河北医科大学学报, doi: 10.3969/j.issn.10073205.2018.11.020.

CHENG Yanxin, CHANG Heping, ZHANG Jian, LIU Yajing， ZHAO Senming*. Efficacy and safety of combined intravenous anesthesia with nalbuphine and propofol during painless induced abortion surgery#br#[J]. Journal of Hebei Medical University, doi: 10.3969/j.issn.10073205.2018.11.020.

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盐酸纳布啡复合丙泊酚用于门诊人工流产术麻醉的疗效及安全性

Efficacy and safety of combined intravenous anesthesia with nalbuphine and propofol during painless induced abortion surgery#br#

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