【摘要】 目的:评价3种不同镇痛麻醉方式在经阴道穿刺取卵术中的使用效果。方法:选择2011年12月—2012年3月进行体外受精-胚胎移植术的患者462例,根据经阴道超声引导下穿刺取卵术患者麻醉方式分为单纯杜冷丁镇痛组(227例)、针刺复合麻醉组(54例)和静脉麻醉组(181例),比较3种麻醉方式的镇痛效果及不良反应。结果:3组患者MⅡ卵率、受精率、卵裂率、临床妊娠率和流产率差异无统计学意义(P>0.05),而获卵率差异有统计学意义(P<0.05)。与单纯杜冷丁镇痛组相比,针刺复合麻醉组和静脉麻醉组镇痛效果和对循环系统的影响类似,患者血压、心率轻度下降,呼吸增快,但都在正常生理范围,差异无统计学意义(P>0.05),而针刺复合麻醉和静脉麻醉具有更为理想的镇痛效果,其术中恶心、出汗的不良反应发生率低(P<0.05),且术中感觉更舒适,同时降低了安定的使用率(P<0.05)。结论:针刺复合麻醉和静脉麻醉均能减轻患者术中疼痛强度及不良反应;减少其他镇静药物的使用率;提高获卵率,对妊娠结局无直接影响。更多还原

【Abstract】 Objective: To compare the clinical efficiencies of three anesthetic techniques used in the transvaginal ultrasound-guided oocyte retrieval. Methods:From December 2011 to March 2012 in our Center, 462 patients undergoing IVF-ET were divided into three groups according to anesthetic techniques during oocyte retrieval,group A(227 cases) used Dolantin(i.m.) only, group B(54 cases) used acupuncture anesthesia, and group C(181 cases) used Propofol(i.v.). The anesthesia effects and adverse effects were evaluated. Results: There were higher oocyte retrieval rate in group C than the other groups(P<0.05),but there were no significant differences in clinical pregnancy rate and miscarriage rate among three groups(P>0.05). The analgesic effects in three groups were similar, but the adverse effects in the group B and C, such as nausea and sweating,were lower(P<0.05) than those in group A. Conclusions:Acupuncture anesthesia and Propofol(i.v.) can reduce pain intensity and adverse effects in patients undergoing transvaginal oocyte retrieval, although treatments do not affect the clinical pregnancy rate and the abortion rate in IVF-ET.更多还原