摘要
目的探讨喷他佐辛静脉自控镇痛对剖宫产术后产妇血浆泌乳素水平的影响。方法选择2011年1月至2013年12月在宜都市第一人民医院住院待产的足月妊娠要求行剖宫产的孕妇210例,利用电脑产生的随机数字将产妇分为喷他佐辛组、芬太尼组和对照组,每组70例。术毕即接静脉自控镇痛泵,持续输注速度为2 m L/h,每次0.5 m L,锁定时间为15 min,使用时间至术后48 h。喷他佐辛组:喷他佐辛4 mg/kg、盐酸格拉斯琼0.05 mg/kg;芬太尼组:芬太尼0.015 mg/kg、盐酸格拉斯琼0.05 mg/kg;对照组未采用静脉自控镇痛。采用视觉模拟评分(VAS)法评估各组的镇痛效果,采用放射免疫分析法检测三组产妇术前、术后24 h及术后48 h血浆泌乳素水平。结果对照组、芬太尼组及喷他佐辛组术后24 h VAS评分分别为(4.6±1.5)分、(1.5±0.7)分、(1.4±0.6)分,48 h VAS评分分别为(4.1±1.4)分、(1.3±0.6)分、(1.1±0.6)分,三组患者术后24、48 h的VAS评分比较差异有统计学意义(P<0.05),喷他佐辛组VAS评分低于芬太尼组和对照组(P<0.05)。对照组、芬太尼组及喷他佐辛组应用静脉自控镇痛24 h后血浆泌乳素水平分别为(281±75)μg/L、(310±87)μg/L、(322±84)μg/L,48 h后血浆泌乳素水平分别为(300±63)μg/L、(356±97)μg/L、(374±86)μg/L,三组患者术后24、48 h的泌乳素水平比较差异有统计学意义(P<0.05),喷他佐辛组泌乳素水平高于芬太尼组和对照组(P<0.05)。结论剖宫产术后采用喷他佐辛静脉自控镇痛治疗,效果确切,值得临床推广应用。
Objective To study the effect of pentazocine with patient-controlled intravenous analgesia on maternal serum prolactin levels after cesarean section. Methods Total of 210 cases of women of full-term pregnancy requiring cesarean section hospitalized in Yidu First People＇s Hospital from Jan. 2011 to Dec. 2013 were included, using computer generated random number, they were divided into pentazocine group, fen- tanyl group and control group ,70 cases in each group. At the end of the operation, the intravenous analgesia pump was connected, sustained infusion rate of 2 mL/h,0.5 mL per time,lock time 15 rain, used till 48 h after surgery. Pentazocine group： pentazocine 4 mg/kg, hydrochloride granisetron 0.05 mg/kg; fentanyl group ： fentanyl 0. 015 mg/kg, granisetron hydrochloride 0. 05 mg/kg; control group without the use of patient- controlled intravenous analgesia. Visual analogue scale（VAS） was adopted to evaluate the analgesic effect of each group. Radiation immunity analysis method was used to inspect the serum prolactin levels before surgery, 24 h and 48 h after surgery of the three groups. Results 24 h VAS score of the control group ,fentanyl group and pentazocine group postoperative were （4. 6 ± 1.5 ）, （ 1.5± 0. 7 ）, （ 1.4 ± 0. 6 ）, 48 h VAS score were （4. 1 ± 1.4）, （ 1.3 ± 0. 6 ）, （ 1.1 ±0. 6）, the 24 h ,48 h VAS score of the three groups were statistically sig- nificantly different（ P 〈 0. 05 ）, and VAS in the pentazocine group was lower than that of the fentanyl group and control group（ P 〈 0. 05 ）. Plasma prolactin levels of the control group, fentanyl group and pentazocine group after 24 h were （281 ± 75 ） μg/L, （ 310 ± 87 ） μg/L, （ 322 ± 84 ） μg/L, after 48 h were （ 300 ± 63 ） μg/L, （356 ±97 ）μg/L, （374 ± 86 ） μg/L,the plasma prolactin levels of the three groups at 24 h ,48 h after surgery were statistically significantly different（ P 〈 0.05 ） , and prolaetin levels in pentazocine group was higher than that in fentanyl group and control group （ P 〈 0. 05 ）. Conclusion Using patient-controlled pentazocine intravenous analgesia after cesarean section has exact effect, thus is worthy of clinical application and promotion.
出处
《医学综述》
2016年第3期578-580,共3页
Medical Recapitulate
关键词
剖宫产
喷他佐辛
静脉自控镇痛
泌乳素
Cesarean section
Pentazocine
Patient-controlled intravenous analgesia
Prolactin
