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目的比较米索前列醇配伍利多卡因与丙泊酚在终止6～10周妊娠的临床价值。方法选择自愿终止妊娠的孕6～10周的初孕妇及有剖宮产史而无引流产阴道分娩史的妇女400例,随机分为2组,观察组和对照组各200例,观察组术前2 h阴道放置米索前列醇片0.4 mg,术时分别在宫颈3、9点部注射2%利多卡因各2.5 ml;对照组术前6 h禁食水,备麻醉机,心电监护仪和氧气,开放静脉通路,有麻醉师缓慢推注丙泊酚2 mg/kg,待意识、睫毛反射消失后常规手术,若术中有肢体动时,追加30～50 mg甚至100 mg,术中持续鼻导管吸氧2 L/min,持续监测血压、脉搏、呼吸血氧饱和度,直至苏醒。结果观察组在手术时间,术中不良反应与对照组比较具有统计意义,而镇痛效果、出血量、流产效果两组对比差异无统计学意义。结论米索前列醇阴道术前2 h放置,术时配伍利多卡因局部麻醉用于孕6～10周人工流产能有效减轻术者疼痛,减少人工流产综合征发生,与丙泊酚相比,是一种简单、安全、经济、方便的方法。
Objective To compare the clinical value of misoprostol with lidocaine and propofol during the termination of 6 ~ 10 weeks gestation. Methods 400 pregnant women who had voluntarily terminated pregnancy at 6-10 weeks of gestation and 400 women with history of cesarean delivery but without vaginal delivery were randomly divided into two groups: observation group (200 cases) and control group (observation group) In the first 2 hours, misoprostol 0.4 mg was injected into the vagina, 2.5 ml each of 2% lidocaine was injected into the cervix at 3,9 points during operation. The control group was given 6-hour fasting water, anesthesia machine and ECG Instrument and oxygen, open venous access, an anesthesiologist slowly push propofol 2 mg / kg, to be aware of, lashes reflex conventional surgery, if there is limb movement, the additional 30 ~ 50 mg or even 100 mg, Continuous nasal catheter oxygen 2 L / min, continuous monitoring of blood pressure, pulse, respiratory oxygen saturation until awakening. Results The observation group had statistically significant differences in operation time and adverse reactions compared with the control group. There was no significant difference in analgesic effect, bleeding volume and abortion effect between the two groups. Conclusion Misoprostol vaginal surgery 2 h before surgery, intraoperative vaginal lidocaine with local anesthesia for 6 to 10 weeks of abortion can effectively reduce the pain and reduce the incidence of induced abortion syndrome, compared with propofol, Is a simple, safe, economical and convenient way.