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目的评价米索前列醇联合笑气用于无痛人工流产术的临床效果。方法将360例孕6～12周流产的患者随机分为实验组210例,对照组150例。两组手术前4h排空膀胱后于阴道后穹隆处放米索前列醇1片(0.2mg),实验组在扩宫前1min行阴道消毒时吸入笑气。比较两组的宫颈松弛情况,术中疼痛情况,操作时间及难易度,术中、后出血情况及副反应的差异。结果①实验组宫颈松弛的显效率(76.6%)显著高于对照组(55.3%)(P<0.01),但总有效率无显著性差异(98.1%、92.0%)(P>0.05);实验组的无痛率(0级)及有效率均(62.4%、90.5%)显著高于对照组(17.3%、64.0%)(P<0.01),无效率(9.5%)则显著低于对照组(36.0%)(P<0.01);实验组的手术操作时间[(7.9±1.2)min]显著低于对照组[(14.7±2.4)min](P<0.01),容易率(80.5%)则显著高于对照组(56.7%)(P<0.01);②两组术中出血量及术后阴道出血停止时间均无显著性差异(P>0.05)。术中对照组3例发生(宫颈)炎症。ILM(未见上皮内病变或阴性)。人工流产综合征,发生率2.0%(3/150),实验组无一例发生。结论米索前列醇联合笑气用于无痛人工流产术,具有宫颈松弛及镇痛作用强、手术时间短且容易的特点,能够减少人工流产综合征的发生,是一种有效、安全的终止早期妊娠的方法。
Objective To evaluate the clinical efficacy of misoprostol in combination with nitrous oxide for painless artificial abortion. Methods A total of 360 patients with pregnancy between 6 and 12 weeks were randomly divided into experimental group (210 cases) and control group (150 cases). Two groups before operation 4h emptying the bladder vaginal posterior fornix on postoperative misoprostol 1 (0.2mg), experimental group 1min before dilatation vaginal disinfection inhalation of nitrous oxide. Compare the two groups of cervical relaxation, intraoperative pain, operation time and difficulty, intraoperative and postoperative bleeding and side effects differences. Results ① The effective rate of cervical relaxation in experimental group (76.6%) was significantly higher than that in control group (55.3%) (P <0.01), but the total effective rate was no significant difference (98.1%, 92.0%) The painless rate (0 grade) and effective rate (62.4%, 90.5%) were significantly higher than those in the control group (17.3%, 64.0%, P <0.01) (36.0%, P <0.01). The operation time in the experimental group was significantly lower than that in the control group [(7.9 ± 1.2) min vs 14.7 ± 2.4 min vs 80.5%, P <0.01) (56.7%) (P <0.01). ② There was no significant difference in intraoperative blood loss and postoperative vaginal bleeding stop time between the two groups (P> 0.05). Intraoperative control group 3 cases (cervix) inflammation. ILM (no intraepithelial lesion or negative). Abortion syndrome, the incidence of 2.0% (3/150), no case of experimental group. Conclusions Misoprostol combined with nitrous oxide is an effective and safe termination of artificial abortion. It has the characteristics of cervical relaxation and analgesia, short operative time and easy operation, and can reduce the incidence of induced abortion syndrome Early pregnancy method.