两种自控镇痛配方在剖宫产术后临床效应比较.docVIP

两种自控镇痛配方在剖宫产术后临床效应比较【中图分类号】 R737 【文献标识码】A【文章编号】1672－3783(2011)04－0021－01 【摘要】 目的：比较两种自控镇痛配方在剖宫产术后的临床效应。方法：将106例剖宫产术后使用自控镇痛泵的产妇随机分为两组，配方A组（含芬太尼等）和B组（含吗啡等）各53例，观察镇痛效果的VSA评分、产后出血量、恶心呕吐程度，肛门排气、自行排尿、术后开奶时间等。结果：两者的镇痛效果相当；但配方A组恶心呕吐的发生率明显低于B组，且肛门排气时间配方A组早于B组；产后出血量和自行排尿、术后开奶时间等两组间无差异。结论：配方A组优于配方B组，在保护产妇镇痛的基础上，促进了产妇早日康复特别是胃肠功能的恢复。? 【关键词】剖宫产术 自控镇痛泵 吗啡 芬太尼 配方? The comparison of clinical efficacy on cesarean section between two self-control analgesia recipe? Xu Xin?1Song Li-Ying?2Peng Yan-Hong?1Wu Jia-Li?2? 【Abstract】Objective:Compare the clinical efficacy on cesarean section between two self-control analgesia recipe ． ［Methods］ 106 maternal using controlled analgesia pump after cesarean section were randomly assigned into tow groups, A group(include fentanyl and so on)and B group(include morphine and so on),53 maternal per group. Observe the analgesic effect by VSA score, postpartum hemorrhage, degree of nausea and vomiting, flatus, voluntary micturition, beginning suckle time after operation and so on. ［Results］ The significant analgesic effect of the two groups is equal, while the incidence of nausea and vomiting of group A is lower than group B, and the flatus time of group A is earlier than group B; The postpartum hemorrhage and open milk time after operation of the two groups have no significant difference.［Conclusion］ Recipe A has a better efficacy than recipe B, recipe A can promote the maternal get well soon, especially for the recovery of gastrointestinal function on the basis of protecting the maternal from pain. ? 【Key words】 cesarean section; controlled analgesia pump; morphine; fentanyl; recipe 剖宫产术后使用自控镇痛泵是一种全新的个体化镇痛模式，具有镇痛效果确定，药物用量少等优点,而且由于自控止痛，产妇情绪稳定，有利于产妇身体的康复，因此，近年来得到了较广泛的应用［1,2］。在自控镇痛(PCEA)中可选用的药物有多种，虽然各种配方镇痛效果确切，仍存在恶心、呕吐、尿潴留等副作用，最常用的药物配方有两类. 一类以吗啡为主［3］，以芬太尼为主［4,5］， 不同的药物配方及输入模式可能产生不同的临床效应。因此，本文在剖宫产术后采用硬膜外自控镇痛，比较了常用两种镇痛药物配方的镇痛效果及副作用。? 1对象与方法? 1.1对象与分组：我院2007年7月-2010年9月的剖宫产术者189例，应用止痛泵者106例，入选产妇年龄22～35岁，体重45～75 kg，无术后并发症。106例随机分为两组，配