双腔道给药加全麻清宫术对7~10周高危妊娠的临床观察

张一沛 周月娟 熊苏力 胡小荣

【摘要】 目的：探讨双腔道给药加全身麻醉清宫术对7～10周高危妊娠患者的临床效果。方法：选取2019年6月-2020年6月在本院治疗的120例高危妊娠患者為研究对象，按照随机数字表法将其分为试验组（n=60）和对照组（n=60）。试验组采用双腔道给药加全身麻醉清宫术，对照组患者仅行全身麻醉负压吸引清宫术。比较两组手术相关指标、宫颈扩张效果、流产结果以及手术并发症发生情况。

结果：试验组手术时间、术后阴道流血时间均明显短于对照组，术中出血量、术后阴道流血量均明显低于对照组，差异均有统计学意义（P<0.05）。试验组宫颈均得到有效软化，宫颈扩张总有效率为100%，明显高于对照组的15.00%，差异有统计学意义（P<0.05）。试验组完全流产率为95.00%，对照组完全流产率为90.00%，两组比较，差异无统计学意义（P>0.05）。试验组手术并发症发生率为6.67%，低于对照组的21.67%，差异有统计学意义（P<0.05）。结论：对7～10周高危妊娠采用双腔道给药加全身麻醉清宫术的治疗方式，能有效促进宫颈扩张、缩短手术时间、减少术中出血量、减少并发症发生，值得临床安全使用。

【关键词】 米非司酮 米索前列醇 卡前列甲酯栓 全麻清宫术 高危妊娠

Clinical Observation of Double-cavity Administration and General Anesthesia for Uterine Surgery in 7-10 Weeks High Risk Pregnancy/ZHANG Yipei， ZHOU Yuejuan， XIONG Suli， HU Xiaorong. //Medical Innovation of China， 2021， 18（30）： -178

[Abstract] Objective： To investigate the clinical effect of double-cavity administration plus general anesthesia for uterine clearing in 7-10 weeks of high-risk pregnancy. Method： A total of 120 high risk pregnancy patients who were treated in our hospital from June 2019 to June 2020 were selected as the research objects， and they were divided into experimental group （n=60） and control group （n=60） according to the random number table method. The experimental group was treated with double-cavity administration and general anesthesia， while the control group was only treated with general anesthesia and vacuum suction. The surgical indicators， cervical dilation effect， miscarriage results and surgical complications were compared between the two groups. Result： The operative time and postoperative vaginal bleeding time of the experimental group were significantly shorter than those of the control group， and the intraoperative blood loss and postoperative vaginal bleeding were significantly lower than those of the control group， the differences were statistically significant （P<0.05）. The cervix of experimental group was effectively softened， and the total effective rate of cervical dilation was 100%， significantly higher than 15.00% of the control group， the difference was statistically significant （P<0.05）. The complete abortion rate of the experimental group was 95.00%， and that of the control group was 90.00%， there was no significant difference between the two groups （P>0.05）. The incidence of surgical complications in experimental group was 6.67%， lower than 21.67% in control group， the difference was statistically significant （P<0.05）. Conclusion： Double-cavity administration and general anesthesia for high risk pregnancy at 7-10 weeks can effectively promote cervical dilation， shorten the operation time， reduce intraoperative bleeding， reduce surgical risks， and reduce complications. It is worthy of clinical safe use.

[Key words] Mifepristone Misoprostol Carboprost Methylate Suppositories General anesthesia High risk pregnancy

First-author’s address： Nanchang Hongdu Hospital of Traditional Chinese Medicine， Nanchang 330038， China

doi：10.3969/j.issn.1674-4985.2021.30.042

药物流产和手术流产是临床常用的终止妊娠方法，高危妊娠患者大多存在自身生殖器官局部病理因素或全身性的病理因素，子宫收缩性较差，临床终止妊娠具有较高的危险性，同时也增加了术后并发症的发生率[1]。药物流产主要表现为出血量多、出血时间长、药物流产不全等问题。……