摘要
目的评估双氯芬酸钠联合曲马多在门诊绝经期妇女宫内节育器取出术中的超前镇痛效果,探讨其临床应用的可行性和有效性。方法回顾性收集2022年2月—2023年1月在湖南省血吸虫病防治所妇产科门诊接受宫内节育器取出术的绝经期妇女的临床数据,采用倾向性评分匹配(PSM)方法进行1∶1匹配。联合组使用双氯芬酸钠栓剂联合曲马多镇痛,对照组使用双氯芬酸钠栓剂联合利多卡因。比较两组手术时间、镇痛效果、不良反应、宫颈软化程度及取出成功率。结果共纳入142例患者,PSM后联合组和对照组均为53例。联合组手术时间为(2.58±0.51)min明显短于对照组的(4.76±1.37)min(P<0.001);疼痛数字评分量表评分为(1.43±0.75)分,也明显优于对照组的(3.87±1.33)分(P<0.001)。联合组的宫颈软化率(94.34%)和取出成功率(96.23%)均显著高于对照组(P<0.05)。2组不良反应发生率差异无统计学意义(P>0.05)。结论双氯芬酸钠联合曲马多在绝经期妇女宫内节育器取出术中的超前镇痛效果显著,能缩短手术时间、减轻术中疼痛、促进宫颈软化并提高取出成功率,且安全性较好,具有较高的临床应用价值。
Objective To evaluate the preemptive analgesic effect of diclofenac sodium combined with tramadol in outpatient intrauterine device(IUD)removal surgery for postmenopausal women,and to explore its feasibility and effectiveness in clinical application.Methods The clinical data of postmenopausal women who underwent IUD removal surgery at the obstetrics and gynecology outpatient department of the Hunan Schistosomiasis Prevention and Control Institute from February 2022 to January 2023 were retrospectively collected.A propensity score matching(PSM)method for 1:1 matching was applied.The combination group received diclofenac sodium suppositories combined with tramadol for analgesia,while the control group received diclofenac sodium suppositories combined with lidocaine.Surgical duration,analgesic effect,adverse reactions,cervical softening,and success rate of IUD removal were compared between the two groups.Results Data from 142 patients were collected.After PSM,there were 53 patients in each group.The surgery time in the combination group was significantly shorter than in the control group(2.58±0.51 vs.4.76±1.37 minutes,P<0.001).The numeric rating scale(NRS)scores in the combination group was better than in the control group(1.43±0.75 vs.3.87±1.33,P<0.001).The cervical softening rate in the combination group was 94.34%,significantly higher than the 71.70%in the control group(P<0.05),while the success rate of IUD removal in the combination group was 96.23%,also significantly higher than 84.91%in the control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Diclofenac sodium combined with tramadol provides significant preemptive analgesic effects in IUD removal surgery for postmenopausal women.It helps to shorten surgical duration,alleviate intraoperative pain,promote cervical softening,and increase the success rate of IUD removal,demonstrating high clinical value.
作者
汪群
章庆
黄薇
WANG Qun;ZHANG Qing;HUANG Wei(Department of Obstetrics and Gynecology,Hunan Schistosomiasis Prevention and Control Institute(Hunan Third People's Hospital),Yueyang 414000,Hunan Province,China;Department of Gynecology,Hunan Provincial People's Hospital,Changsha 410001,China)
出处
《药物流行病学杂志》
2025年第2期151-156,共6页
Chinese Journal of Pharmacoepidemiology
基金
2022年湖南省人民医院医联体专项科研基金项目(2022YLT013)。
关键词
绝经期妇女
宫内节育器取出术
双氯芬酸钠
曲马多
超前镇痛
Postmenopausal women
intrauterine device removal
Diclofenac sodium
Tramadol
Preemptive analgesia
