目的评价四种无痛人工流产术的效果及优缺点。方法将研究对象400例随机分为A、B、C、D四组(每组100例),在人工流产术中分别给予阿托品配伍芬太尼(A组)、异丙酚(B组)、芬太尼+异丙酚(C组)、利多卡因(D组),比较各组临床效果及不良反应。结果镇痛效果C组最佳,总有效率为98%,D组最差,总有效率为64%。A、B、C三组患者心率、呼吸均明显减慢,血氧饱和度均明显降低,与术前各指标比较有统计学意义,但三组间比较差异不明显。D组孕妇术中各指标与术前比较变化不明显。A、B两组术后眩晕和恶心呕吐发生率分别为18%和16%2、8%和19%,明显高于C组、D组的7%和5%2、%和3%,有统计学意义。C组宫颈松弛效果为最明显,有效率90%,明显高于其他三组(P<0.05),其他三组间差异不明显。B组、C组出现术后宫缩痛发生率为32%、27%,明显低于A组、D组的47%、56%,差异有统计学意义(P<0.05)。四组中均未出现人工流产综合征的情况。各组间术中阴道流血量无明显差异。结论无痛人工流产术以阿托品配伍芬太尼+异丙酚效果最好,但须注意术中呼吸、血压的监测及药量。其他方法有其独特优点,根据手术人员及条件可适当选择。 Objective To evaluate the efficacy, advantages and disadvantages of four painless abortion techniques. Methods 400 cases were randomly divided into four groups (A, B, C and D) (100 cases in each group). The patients were given atropine and fentanyl (group A), propofol (group B) Fentanyl + propofol (group C) and lidocaine (group D). The clinical effects and adverse reactions in each group were compared. Results The analgesic effect was the best in group C, the total effective rate was 98%, the worst in group D, the total effective rate was 64%. The heart rate and respiration of A, B, and C groups were significantly slowed down and oxygen saturation were significantly decreased, which was statistically significant compared with preoperative indexes, but the difference was insignificant among the three groups. The indexes of pregnant women in group D had no obvious changes compared with those before operation. The incidences of postoperative vertigo and nausea and vomiting in group A and B were 18% and 16% 2,8% and 19%, respectively, which were significantly higher than those in group C and group D (7% and 5%, 2% and 3% Statistical significance. The effect of cervical relaxation in group C was the most obvious, the effective rate was 90%, which was significantly higher than the other three groups (P <0.05). The other three groups showed no significant difference. The incidence of postoperative uterine pain in group B and group C was 32% and 27%, which was significantly lower than that in group A and group D (47% and 56%, respectively) (P <0.05). No abortion syndrome occurred in any of the four groups. There was no significant difference in intraoperative vaginal bleeding between groups. Conclusion Painless abortion with atropine compatibility of fentanyl + propofol the best, but should pay attention to intraoperative breathing, blood pressure monitoring and dosage. Other methods have their unique advantages, according to the surgical staff and conditions may be appropriate to choose.