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目的研究罗红霉素、替硝唑、卡孕栓、阿托品、地西泮续贯应用(RT-M-AD方案)对负压吸引人流术的临床价值。方法选择2008年6月至2008年11月厦门市第二医院妇产科收治的52例要求终止计划外妊娠的门诊早孕女性,续贯应用罗红霉素和替硝唑以预防感染、卡孕栓软化宫颈并促进术后子宫复旧、阿托品预防迷走神经反射、地西泮镇静,将相关技术指标与同期相匹配的56例芬太尼、异丙酚无痛人工流产组进行对比。结果RT-M-AD方案组手术前后平均动脉压和脉搏下降幅度[分别为(5.98±1.25)mmHg和(4.46±1.34)mmHg]显著性低于无痛人流组[分别为(9.52±3.32)mmHg和(8.46±2.12)mmHg,1mmHg=0.133kPa](P<0.01);松弛宫颈作用显著性优于无痛人流组(有效率96.2%对71.4%,P<0.01),手术用时[(42.23±4.56)s]、术中出血量[(10.25±3.87)mL]、术后子宫出血停止时间[(70.35±9.46)h]均显著性低于无痛人流组[分别为(91.39±9.87)s,(16.37±5.56)mL,(90.68±12.32)h](P<0.01)。结论RT-M-AD方案在配合负压吸引人工流产术终止早期妊娠中有良好的综合价值。
Objective To study the clinical value of roxithromycin, tinidazole, carbamazepine, atropine and diazepam (RT-M-AD regimen) for vacuum-assisted abortion. Methods From June 2008 to November 2008, 52 cases of outpatients with premature unplanned pregnancy who were admitted to Obstetrics and Gynecology Department of the Second Hospital of Xiamen City were enrolled in this study. Roxithromycin and tinidazole were used to prevent infection, Suppository softening the cervix and promoting postoperative uterine involution, atropine to prevent vagal reflex, diazepam sedation, the relevant technical indicators and the same period matching 56 cases of fentanyl, propofol painless abortion group were compared. Results The mean arterial pressure and pulse decline before and after surgery in the RT-M-AD group were (5.98 ± 1.25) mmHg and (4.46 ± 1.34) mmHg, respectively, which were significantly lower than those in the painless group [9.52 ± 3.32 mmHg and (8.46 ± 2.12) mmHg, 1mmHg = 0.133kPa] (P <0.01). The cervical relaxation was significantly better than that of the painless abortion group (effective rate 96.2% vs 71.4%, P <0.01) ± 4.56) s], intraoperative blood loss [(10.25 ± 3.87) mL] and postoperative uterine bleeding stop time [(70.35 ± 9.46) h] were significantly lower than those in the painless group [91.39 ± 9.87 s, (16.37 ± 5.56) mL, (90.68 ± 12.32) h] (P <0.01). Conclusion The RT-M-AD regimen has a good overall value in terminating early pregnancy with vacuum induced abortion.