剖宫产术后自控镇痛对母婴的影响  

Effects of patient controlled analgesia on both mother and neonate after cesarean section.

作　　者：王瑛[1] 岳书勤[1] 辛勤[1] 

机构地区：[1]首都医科大学附属复兴医院,北京100038

出　　处：《中国实用妇科与产科杂志》2004年第9期551-552,共2页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的　观察剖宫产术后产妇自控镇痛对母婴的影响。方法　 2 0 0 2年 1月至 2 0 0 3年 1月首都医科大学附属复兴医院将剖宫产产妇 2 16例分为观察组和对照组 ,两组均为连续硬膜外麻醉 ,手术结束时 ,观察组将自控镇痛泵接在硬膜外管上。术后分别取产妇肘静脉血、初乳、尿及新生儿尿 ,测定吗啡含量 ;观察镇痛效果及副反应。结果　与对照组比较观察组镇痛效果明显 (P <0 0 5 )。观察组血吗啡质量浓度 5 0～ 12 6 0 μg/L ,初乳吗啡质量浓度 5 0～ 33 6 μg/L ,91 8%的产妇尿吗啡呈阳性 ,12 7%的新生儿尿吗啡呈阳性。随访 1年两组婴儿的体格及发育商比较 ,P >0 0 5。结论　剖宫产术后硬膜外腔应用吗啡镇痛 。Objective To study the effects of patient-controlled analgesia (PCA) on both mother and n eonate after cesarean section. Methods Two hundred and sixteen puerpera who took cesarean section with continuous epidu ral anesthesia were randomly divided into study group and control group.After th e operation,the PCA was joined to the tube of epidural anesthesia. Colostrum and plasma, urine samples of puerpera and neonate were collected,and m orph ine level were tested.We observed the analgesia effects,vital signs and side eff ects.The development of body and intelligence was followed up for 1 year.Results The analgesia effects were obvious in study group (P<0.05),and there were n o statistically significant difference in the respiratory rate,heart rate,blood p ressure between the two groups(P>0.05).The concentration of morphine in blo od was 5.0～126.0μg/L,and it was 5.0～33.6μg/L in colostrum.Morphine was p osit ive in 91.8% urine of puerpera,while it was positive in 12.7% neonate.There wa s no difference in both body and intelligent development of the two groups,P >0.05. Conclusion As PCA with morphine after cesarean section,morphine has no side-effects on bot h mother and their neonates.

关 键 词：剖宫产 术后自控镇痛 连续硬膜外麻醉 药物不良反应 母婴预后 

分 类 号：R719.8[医药卫生—妇产科学] R614.42[医药卫生—临床医学]