剖宫产术后病人自控硬膜外镇痛对血浆泌乳素影响.doc

剖宫产术后病人自控硬膜外镇痛对血浆泌乳素影响【摘要】目的：探讨剖宫产术后病人自控硬膜外镇痛对血浆泌乳素的影响。方法：选择80例健康足月产妇，择期在硬膜外麻醉下行剖宫产术。术毕随机分为两组，镇痛组（n=40）行病人自控硬膜外镇痛（PCEA），持续72小时（2 ml/h）。对照组（n=40）术毕拔出硬膜外导管。两组采用化学发光免疫分析法测定血浆泌乳素（PRL）浓度。结果：镇痛组视觉模拟评分（VAS）明显低于对照组（P＜0.01）。两组术后PRL均较术前明显升高（P＜0.01），镇痛组术后PRL高于对照组，24小时差异具有显著性（P＜0.05），48小时差异具有极显著性（P＜0.01）。相关分析表明镇痛组术后24小时与48小时VAS评分与血浆PRL浓度呈负相关性（P＜0.01）。镇痛组初乳时间较对照组提前（P＜0.05）。结论：剖宫产术后病人自控硬膜外镇痛能促进PRL分泌，促进提前泌乳。 【关键司】剖宫产术；病人自控硬膜外镇痛；泌乳素 文章编号：1009-5519（2007）24-3641-02 中图分类号：R614 文献标识码：A Effect of patient controlled epidural analgesia on plasma prolactin level after cesarean section YAN Shi-jian1,QIAN Ling2,NIU Feng-juan3 (1.Department of Anesthesiology,2.department of Gyneclolgy and Obster\trics,3.Operation Room,The People’s Hospital of Donghai,Jiangsu 222300,China) 【Abstract】Objective:To study the effect of patient controlled epidural analgesia (PCEA) on plasma prolactin leval after cesarean section.Methods:Eighty healthy parturients at term undergoing elective cesaarean into two groups.Group I,40 cases of cesarean section received PCEA.Group II did not receive postoperative management .PCEA was performed for 72 hrs (2 ml/h).The plasma prolaction level was measured with radioimmunossay (RIA).Results:VAS paia score after operation was significantly lower in PCEA than in the control group (P＜0.01).In both groups,prolactin levels were significantly higher after operation (P＜0.01).The increase was greater in PPCEA group (P＜0.05).There were negative correlations between VAS scores (24 h and 48 h postoperation )and the plasma concentration of prolaction(P＜0.01).Lactation started earlier in PCEA group than in control group (P＜0.05).Conclusion:PCEA after cesarean section prodused a satisfactory increased secretion of prolaction and improved colostrum. 【Key words】Cesarean section;PCEA;Prolactin 母乳是新生儿最佳食物，剖宫产术后的剧烈疼痛往往会抑制母乳的分泌。目前，病人自控硬膜外镇痛（PCEA）已广泛应用于术后镇痛，而镇痛对剖宫产术后产妇泌乳素（PRL）的影响报道还较少，现将我们的观察结果报道如下。 1 资料与方法 1.1 资料：本组80例健康足月产妇，年龄20～36岁，均择期在连续硬膜外麻醉下行新式剖宫产。 1.2 方法：所有病