目的 探讨剖宫产术后舒芬太尼静脉镇痛和双氯芬酸钠塞肛两种止痛方法对血清泌乳素的影响。方法 选取2015-01至2016-12在医院行剖宫产手术的产妇80例,手术后随机分为两组进行镇痛处理。观察组给予舒芬太尼自控静脉镇痛(PCIA),对照组用双氯芬酸钠塞肛,分别于术前,术后12、24、48 h测定两组舒芬太尼的血药浓度和血浆中的泌乳素水平,通过VAS评分评估镇痛效果,记录两组产妇产后的初乳开始时间、24 h哺乳次数并观察术后是否发生恶心呕吐等不良反应。结果 对照组12、24、48 h的VAS评分显著低于观察组(P<0.05);两组产妇术后泌乳素水平均较术前明显升高(P<0.05),观察组术后12、24、48 h泌乳素分别为(249.32±9.65)mmol/L、(278.33±12.56)mmol/L和(290.29±10.28)mmol/L,明显高于对照组(213.24±11.34)mmol/L、(224.89±12.34)mmol/L和(236.43±10.09)mmol/L(P<0.05)。观察组术后恶心、呕吐的例数明显少于对照组。结论 剖宫产术后给予舒芬太尼静脉镇痛,镇痛效果好,不良反应少,能够明显增加产妇泌乳素的分泌,有利于产后早期的母乳喂养。
Abstract
Objective To investigate the effect of intravenous sufentanil analgesia and diclofenac sodium on serum prolactin after cesarean section.Methods Eighty cases of maternal cesarean section were treated in our hospital. These patients were randomly divided into two groups for analgesic treatment. The observation group received controlled intravenous sufentanil analgesia (PCIA), while the control group was treated with diclofenac sodium. The plasma concentrations of sufentanil and plasma prolactin levels were measured preoperatively and at 12 h, 24 h and 48 h postoperatively. The analgesic effect was assessed by VAS score. The start time of colostrum and the number of feedings of the two groups were recorded and such adverse reactions as nausea and vomiting were observed.Results The VAS score of the control group at 12 h, 24 h and 48 h was significantly lower than that of the observation group (P<0.05). The levels of prolactin in the two groups were significantly higher after operation (P<0.05), which were (249.32±9.65)mmol、(278.33±12.56)mmol and (290.29±10.28)mmol at 12h, 24 h and 48 h respectively, compared to (213.24±11.34)mmol、(224.89±12.34)mmol and(236.43±10.09)mmol in the control group(P<0.05). Postoperative nausea and vomiting in the observation group were significantly less frequent than in the control group.Conclusions Intravenous analgesia with sufentanil after cesarean section is effective, with fewer adverse reactions, which can obviously increase the secretion of prolactin in mothers and contribute to early postnatal breastfeeding.
关键词
舒芬太尼 /
泌乳素 /
剖宫产术 /
镇痛
Key words
sufentanil /
prolactin /
cesarean section /
analgesia
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