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目的探讨小剂量丙泊酚在人工流产术静脉麻醉中的临床效果。方法选取2014年1月—2015年10月徐州医学院附属第三医院行人工流产术患者102例,随机分为对照组与观察组,各51例。患者在静脉注射枸橼酸芬太尼基础上,对照组静脉注射丙泊酚总量,观察组按丙泊酚总量减去60 mg的量进行静脉注射,剩余丙泊酚持续静脉微泵滴注。比较两组患者麻醉效果、麻醉起效、手术、意识恢复、定向力恢复时间、丙泊酚使用总量、平均动脉压、心率、血氧饱和度及不良反应发生情况。结果观察组麻醉优良率高于对照组(P<0.05)。观察组患者麻醉起效、手术、意识恢复、定向力恢复时间短于对照组,丙泊酚使用总量少于对照组(P<0.05)。术前两组患者平均动脉压、心率、血氧饱和度比较,差异无统计学意义(P>0.05);观察组术中平均动脉压高于对照组,术中、术毕心率、血氧饱和度高于对照组(P<0.05);术毕两组患者平均动脉压比较,差异无统计学意义(P>0.05);对照组患者术中、术毕心率、血氧饱和度低于术前,术中平均动脉压低于术前(P<0.05);观察组患者术中、术毕心率、血氧饱和度与术前比较,差异无统计学意义(P>0.05,见表3)。观察组患者平均动脉压下降≥20%、体动、心率<50次/min、胃肠道反应发生率低于对照组(P<0.05)。结论持续小剂量丙泊酚静脉滴注在人工流产术麻醉中的应用效果较理想,具有起效快、清醒快、生命体征平稳、不良反应少等优势。
Objective To investigate the clinical effect of low-dose propofol in intravenous anesthesia induced by artificial abortion. Methods From January 2014 to October 2015, 102 cases of induced abortion in the Third Affiliated Hospital of Xuzhou Medical College were randomly divided into control group and observation group, with 51 cases in each group. Patients on the basis of intravenous injection of fentanyl citrate, the control group intravenous injection of propofol, the observation group by the total amount of propofol minus 60 mg for intravenous injection, the remaining propofol intravenous micro-pump drop Note. The anesthetic effect, anesthesia onset, operation, consciousness recovery, recovery time of directional force, total propofol use, mean arterial pressure, heart rate, oxygen saturation and adverse reactions were compared between the two groups. Results The good rate of anesthesia in the observation group was higher than that in the control group (P <0.05). The onset of anesthesia, operation, consciousness recovery and recovery time of directional force in the observation group were shorter than those in the control group, and the total amount of propofol used in the observation group was less than that of the control group (P <0.05). The mean arterial pressure, heart rate and oxygen saturation in the two groups before operation were not significantly different (P> 0.05). The mean arterial pressure in the observation group was higher than that in the control group during operation. The intraoperative and postoperative heart rate, oxygen saturation (P <0.05). There was no significant difference in mean arterial pressure between the two groups at the end of surgery (P> 0.05). In the control group, the intraoperative and postoperative heart rate and oxygen saturation were lower than those before operation , Mean arterial pressure was lower than that before operation (P <0.05). There was no significant difference between the two groups in the intraoperative and postoperative heart rate and oxygen saturation (P> 0.05, Table 3). In the observation group, the mean arterial pressure was decreased by 20%, body movement and heart rate were less than 50 beats / min, and the incidence of gastrointestinal reactions was lower than that of the control group (P <0.05). Conclusion Continuous low-dose propofol infusion is more effective in anesthesia induced by induced abortion. It has the advantages of rapid onset, fast awake, stable vital signs and few adverse reactions.