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目的探讨直肠给予双氯芬酸钠栓与阴道给予米索前列醇在门诊无创宫腔镜检查中减少患者疼痛的差异。方法回顾性分析广州市妇女儿童医疗中心2016年4月至2016年12月在门诊行无创宫腔镜检查患者196例。患者分成3组。其中A组63例,术前未给予任何药物处置;B组51例,均术前2 h接受阴道给药米索前列醇200μg;C组82例,术前60 min直肠给予双氯芬酸钠栓100 mg。记录患者疼痛程度,按从0分(无痛)到10分(剧痛)可视量化评分,比较宫腔镜检查时间、术中不良反应、术后镇痛的需求及心脑综合征(PASS)发生情况。结果宫腔镜检查时间A组(7.61±2.23)min,B组(7.04±2.95)min,C组(6.12±1.72)min,3组差异无统计学意义;术中C组发生PASS和不良反应0例,明显低于B组,差异有统计学意义(P<0.05);术中C组发生中重度疼痛7例(8.75%),分别与A组和B组比较,差异均有统计学意义(P<0.05)。结论门诊无创宫腔镜检查术前应用双氯芬酸钠栓具有疼痛轻、无需麻醉、不良反应发生率低、效果好等优点。
Objective To investigate the difference of reducing pain in patients receiving rectal diclofenac sodium suppository and vaginal administration misoprostol in outpatient non-invasive hysteroscopy. Methods A retrospective analysis of Guangzhou Women and Children Medical Center from April 2016 to December 2016 in outpatient noninvasive hysteroscopy in patients with 196 cases. Patients were divided into 3 groups. Among them, 63 cases in group A were treated with no drugs preoperatively. In group B, 51 patients received vaginal administration of misoprostol 200 μg 2 h before surgery and 82 patients in group C received diclofenac sodium suppository 100 mg . The patient’s pain level was recorded. The visual acuity score was scored from 0 (no pain) to 10 (pain), and the time of hysteroscopy, adverse reactions during surgery, postoperative analgesia and PASS ) Happened. Results The time of hysteroscopy in group A was (7.61 ± 2.23) min, in group B (7.04 ± 2.95) min, in group C (6.12 ± 1.72) min, there was no significant difference between the three groups; PASS and adverse reactions 0 cases were significantly lower than those in group B, the difference was statistically significant (P <0.05); in group C, moderate-severe pain occurred in 7 cases (8.75%), respectively, compared with group A and group B, the differences were statistically significant (P <0.05). Conclusion Noninvasive hysteroscopy in preoperative application of diclofenac sodium suppository with light pain, without anesthesia, the incidence of adverse reactions, the effect is good and so on.