【摘要】 目的 评估环泊酚复合阿芬太尼用于人工流产手术的有效性和安全性。方法 选取2024年1—3月在江西省妇幼保健院行无痛人工流产手术的患者120例为研究对象，随机分为环泊酚组（C组）和丙泊酚（P组）,每组各60例。两组患者均先静注10μg/kg阿芬太尼，随后C组患者静注0.4 mg/kg环泊酚，P组患者静注2 mg/kg丙泊酚，直至患者改良觉醒/镇静评分（MOAA/S）≤1时开始手术。记录患者麻醉诱导成功率、诱导时间及苏醒时间，记录患者麻醉诱导前（T0）、诱导成功即刻（T1）、诱导成功后5 min（T2）的平均动脉压（MAP）、心率（HR）及血氧饱和度（SPO₂）,同时对患者围术期相关不良事件发生情况进行记录，包括术中注射痛、低血压、心动过缓、低氧血症、呛咳、体动反应（影响手术操作）、术后恶心呕吐及术中知晓等并发症，在患者离院前，采用视觉模拟评分（VAS）评估患者腹痛情况，并统计患者满意度评分。结果 两组患者的麻醉诱导均获得成功，成功率均达100.0%。两组患者麻醉诱导时长[（58.9±13.0）s vs.（56.1±9.4）s]、术后苏醒时间[（9.0±2.3）min vs.（8.4±3.6）min]比较，差异均无统计学意义（t=0.986、1.064,均P>0.05）。在T0时，两组患者MAP[（88.2±9.7）mm Hg vs.（86.4±5.9）mm Hg]、HR[（86.5±10.6）次/分vs.（87.5±14.7）次/分]及SPO₂[（99.3±1.4）%vs.（99.4±1.4）%]水平比较，差异均无统计学意义（t=1.192、0.418及0.381,均P>0.05）;与T0时比较，C组患者在T2时MAP、HR明显降低（P<0.05）,P组患者在T1、T2时MAP、HR明显降低，在T1时SPO₂明显降低（P<0.05）;两组患者生命体征组间比较显示，在T1、T2时，C组患者MAP[T1（84.8±9.0）mm Hg、T2（77.3±7.8）mm Hg]、HR[T1（84.5±9.1）次/分、T2（81.8±7.8）次/分]明显高于P组患者[T1（74.4±7.2）mm Hg、（77.5±9.3）次/分，T2（73.9±6.4）mm Hg、（78.3±10.1）次/分],差异均有统计学意义（t=6.798、4.062、2.539及2.075,均P<0.05）,在T1时C组患者SPO₂[（99.1±1.5）%]明显高于P组患者[（98.2±1.7）%],差异有统计学意义（t=3.000,P<0.05）。在不良反应方面，C组患者术中注射痛、低氧血症的发生率（10.3%、5.2%）明显低于P组患者（48.2%、17.9%）,差异均有统计学意义（χ²=19.866、4.538,均P<0.05）。两组患者离院时腹痛视觉模拟评分法（VAS）评分[（2.3±1.3）分vs.（2.0±1.0）分]比较，差异无统计学意义（t=1.378,P>0.05）。C组患者对围术期管理的整体满意度评分为（9.2±0.8）分，明显优于P组的（8.3±1.7）分，差异有统计学意义（t=3.637,P<0.05）。结论 环泊酚复合阿芬太尼用于人工流产手术中效果确切，患者循环呼吸抑制较轻，注射痛发生概率较小，患者满意度较高。更多还原

【Abstract】 Objective To evaluate the efficacy and safety of ciprofol combined with alfentanil for abortion.Methods 120 patients scheduled for elective abortion in general anesthesia at Jiangxi Maternal and Child Health Hospital（January to March 2024） were randomly assigned into two groups: the ciprofol group（Group C,n=60） and the propofol group（Group P,n=60）.Both groups received an initial intravenous injection of 10 μg/kg alfentanil, followed by 0.4 mg/kg ciprofol in Group C and 2 mg/kg propofol in Group P until the patients achieved a Modified Observer’s Assessment of Alertness/Sedation（MOAA/S） score of ≤1.The anesthesia induction success rate, induction time, and recovery time were recorded.The meanarterial pressure（MAP）,heart rate（HR）,oxygen saturation（SPO₂） before induction（T0）, immediately after successful induction（T1）, and 5 minutes after induction（T2） were compared.The incidence of adverse events, including injection pain, hypotension, bradycardia, hypoxemia, coughing, body movements interfering with surgery, postoperative nausea and vomiting, and intraoperative awareness were observed.The Visual Analog Scale（VAS） scores and patient satisfaction before discharge were recorded.Results The anesthesia induction of both groups of patients was successful, with a success rate of 100.0% for both.Comparison of anesthesia induction duration [（58.9±13.0）s vs.（56.1±9.4） s] and postoperative recovery time [（9.0±2.3）min vs.（8.4±3.6）min] between the two groups of patients, there were no statistically significant differences（t=0.986, 1.064,all P>0.05）.At T0, MAP[（88.2±9.7） mm Hg vs.（86.4±5.9） mm Hg], HR [（86.5±10.6） times per minute vs.（87.5±14.7） times per minute], and SpO₂ [（99.3±1.4）% vs.（99.4±1.4）%] were comparable between groups, there were no statistically significant differences（t=1.192,0.418,0.381, all P>0.05）; a significant reduction in MAP and HR was observed at T2 compared to T0 in Group C（P<0.05）.Group P exhibited significant decreases in both MAP and HR at T1 and T2, along with significantly reduced SpO₂ at T1（all P<0.05）;Group C maintained significantly higher hemodynamic parameters than Group P at both time points: MAP was higher at T1 [（84.8±9.0）mm Hg vs.（74.4±7.2） mm Hg, t=6.798, P<0.05] and at T2 [（77.3±7.8） mm Hg vs.（73.9±6.4） mm Hg, t=2.539, P<0.05], Similarly, HR remained significantly elevated in Group C at T1 [（84.5±9.1） times per minute vs.（77.5±9.3） times per minute, t=4.062, P<0.05] and T2 [（81.8±7.8） times per minute vs.（78.3±10.1） times per minute, t=2.075, P<0.05], with all comparisons reaching statistical significance（P<0.05）,the SpO₂ in Group C was significatly higher than that in group P at T1 [（99.1±1.5）% vs.（98.2±1.7）%, t=3.000,P<0.05)].As adverse events, the Group C showed superior safety profiles, with significantly reduced incidence of injection pain（10.3% vs. 48.2%, χ²=19.866） and hypoxemia（5.2% vs. 17.9%, χ²=4.538） compared to Group P（all P<0.05）.No significant difference was found in discharge VAS scores between groups[（2.3±1.3） scores vs.（2.0±1.0） scores, t=1.378,P>0.05].Patient satisfaction scores were significantly higher in Group C [（9.2±0.8） scores vs.（8.3±1.7） scores, t=3.637, P<0.05].Conclusion The ciprofol-alfentanil combination demonstrates reliable efficacy for abortion, with mild circulatory and respiratory depression, significantly lower incidence of injection pain, and superior patient satisfaction.更多还原