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目的:研究探索无痛可视人工流产术有效性与安全性之间的相关因素。方法:比较五组麻醉药(瑞芬太尼、瑞芬太尼+丙泊酚、瑞芬太尼+咪唑安定、丙泊酚、丙泊酚+芬太尼)作用时间、止痛效果、副反应及对体温、呼吸、脉搏、血压及血氧饱和度的影响等,严格操作规范,完善各环节工作,总结有效性与安全性之间的相关因素。结果:五组麻醉药中对诱导、手术、苏醒时间和定向力恢复时间以瑞芬太尼+丙泊酚组最佳,镇痛效果显著,差异具有统计学意义,P<0.05;对生命指征的影响以瑞芬太尼+丙泊酚组最小,安全系数最高,经统计学处理,P<0.05。瑞芬太尼+丙泊酚最佳用药量分别为0.9～1.4μg/kg、1.9～2.2 mg/kg。无痛可视人工流产术有效性与安全性之间的相关因素有:手术适应证、全麻药组合及剂量的选择、施术环境及设备的配置、受术者知情同意、手术医生、护士和麻醉医师的责任心及技术水平、术后指导及随访等。结论:无痛可视人工流产术有效性安全性与手术适应证、全麻药组合及剂量的选择、施术环境及设备的配置、受术者知情同意、手术医生、护士和麻醉医师的责任心及技术水平、术后指导及随访等因素有关。
Objective: To study the correlation between the effectiveness and safety of exploring painless visual abortion. Methods: The effects of five groups of anesthetics (remifentanil, remifentanil + propofol, remifentanil + midazolam, propofol, propofol + fentanyl) on analgesic effect, side effects And the impact on body temperature, respiration, pulse, blood pressure and oxygen saturation, strict operating practices, improve all aspects of work, summarizes the relevant factors between effectiveness and safety. Results: The recovery time of induction, surgery, recovery time and orientation in the five groups of anesthetics were the best with remifentanil + propofol group, the analgesic effect was significant, the difference was statistically significant, P <0.05; The impact of remifentanil + propofol group minimum impact, the highest safety factor, the statistical analysis, P <0.05. The best dosage of remifentanil and propofol were 0.9 ~ 1.4μg / kg and 1.9 ~ 2.2mg / kg, respectively. The related factors between the effectiveness and safety of painless visual abortion are as follows: surgical indications, combination of general anesthesia and dose selection, surgical environment and equipment configuration, subject informed consent, surgeons and nurses and Anesthesiologist’s sense of responsibility and skill, postoperative guidance and follow-up. CONCLUSIONS: The safety and surgical indications of painless visual abortion, the selection and dosage of general anesthetics, the deployment of the surgical environment and equipment, the informed consent of the surgeon, the sense of responsibility of the surgeon, nurse and anesthesiologist And technical level, postoperative guidance and follow-up and other factors.