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局部麻醉下采用手动真空抽吸进行手术流产:一项关于可行性及女性可接受性的试点研究。

Surgical abortion using manual vacuum aspiration under local anaesthesia: a pilot study of feasibility and women's acceptability.

作者信息

Hamoda Haitham, Flett Gillian M M, Ashok Premila W, Templeton Allan

机构信息

Department of Obstetrics and Gynaecology, University of Aberdeen, Aberdeen, UK.

出版信息

J Fam Plann Reprod Health Care. 2005 Jul;31(3):185-8. doi: 10.1783/1471189054484004.

Abstract

OBJECTIVE

Studies from the USA have reported the efficacy and high acceptability of surgical abortion using manual vacuum aspiration (MVA) under local anaesthesia. The aim of this study was to assess the feasibility, acceptability and efficacy of surgical abortion using MVA under local anaesthesia for termination of pregnancy up to 63 days' gestation, within a UK National Health Service setting.

METHODS

Surgical abortion was carried out using MVA under local anaesthesia. Women's satisfaction with the procedure, and pain and anxiety levels, were assessed. The main outcome measures were: (1) feasibility assessed through successful completion of the procedure without the need for general anaesthetic or conversion to suction vacuum aspiration, (2) efficacy assessed through complete uterine evacuation without the need for further medical or surgical intervention and (3) women's acceptability of the procedure.

RESULTS

The mean (SD) gestation was 50 (9.4) days. A total of 55/56 (98%) women had a successful procedure and did not require any further surgical or medical treatment. Fifty-five (98%) women were satisfied with the procedure, 48 (86%) said they would recommend it to a friend and 45 (80%) said they would have the same method again in the future. Anxiety levels, as reflected by the visual analogue scales, showed a significant fall in anxiety scores following the procedure (p<0.01).

CONCLUSIONS

Surgical abortion using MVA under local anaesthesia is effective and acceptable to women. These findings now need to be assessed in the context of a randomised trial.

摘要

目的

美国的研究报告了局部麻醉下采用手动真空抽吸术(MVA)进行手术流产的有效性和高度可接受性。本研究的目的是在英国国家医疗服务体系内,评估局部麻醉下采用MVA进行手术流产以终止妊娠至63天孕期的可行性、可接受性和有效性。

方法

在局部麻醉下采用MVA进行手术流产。评估了女性对该手术的满意度、疼痛程度和焦虑水平。主要结局指标为:(1)通过无需全身麻醉或转换为电动负压吸引术成功完成手术来评估可行性;(2)通过无需进一步药物或手术干预实现完全清宫来评估有效性;(3)女性对该手术的可接受性。

结果

平均(标准差)孕周为50(9.4)天。共有55/56(98%)的女性手术成功,无需任何进一步的手术或药物治疗。55名(98%)女性对该手术满意,48名(86%)表示会向朋友推荐,45名(80%)表示未来会再次采用相同方法。视觉模拟量表反映的焦虑水平显示,手术后焦虑评分显著下降(p<0.01)。

结论

局部麻醉下采用MVA进行手术流产对女性有效且可接受。这些发现现在需要在随机试验的背景下进行评估。

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