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目的探讨笑气吸入与宫颈注射利多卡因的联合镇痛效果对绝经后妇女宫内节育环取出的影响。方法2003年3月~2005年8月广州市第一人民医院妇产科68例绝经后妇女带宫内节育环者随机分2组施实取环手术。观察组:笑气吸入镇痛与利多卡因宫旁注射联合组;对照组:利多卡因宫旁局部封闭麻醉组。结果绝经2年内:观察组22例IUD全部成功取出,有效率为100%;对照组17例取出有效率为80.95%,绝经2年后:观察组12例成功取出,有效率为85.71%;对照组4例取出,有效率为36.36%。二者比较差异有统计学意义(P<0.01)。结论笑气吸入与利多卡因宫旁注射联合镇痛能明显松弛子宫颈内口,有利于探针顺利进入宫腔,同时笑气吸入的镇痛效果消除了患者对绝经后取环手术的害怕、恐惧心理为成功取出IUD起着重要作用。绝经2年内取环总有效率为95.35%,因此,宫内节育环在绝经2年内应及时取出。
Objective To investigate the effect of combined analgesic effect of inhaled nitrous oxide and lidocaine injection on postoperative IUD insertion in postmenopausal women. Methods From March 2003 to August 2005, 68 cases of postmenopausal women with IUD in gynecology and obstetrics department of the First People ’s Hospital of Guangzhou were randomly divided into two groups. Observation group: nausea inhalation analgesia and lidocaine combined with uterine injection; control group: lidocaine local anesthesia group. Results In the 2 years after the menopause, all 22 cases of IUD in the observation group were successfully removed, with an effective rate of 100%. In the control group, the effective rate was 80.95%. After 2 years of menopause, 12 cases of the observation group were successfully removed with an effective rate of 85.71% Group 4 cases were removed, the effective rate was 36.36%. The difference was statistically significant (P <0.01). Conclusion Combined inhalation of nitrous oxide and lidocaine combined with parenteral analgesia can obviously relax the cervix of the cervix and facilitate the successful entry of the probe into the uterine cavity. Meanwhile, the analgesic effect of inhaled nitrous oxide eliminates the fear of postoperative menorrhagia Fearfulness plays an important role in the successful removal of IUD. Menopause taken within 2 years the total effective rate was 95.35%, therefore, IUD in menopause within 2 years should be promptly removed.