不同镇痛方式对剖宫产术后镇痛效果及并发症的影响  

Impact of different analgesia modes on the analgesic effect and complications after cesarean section

作　　者：张旱愉[1] 崔睿[1] 王宝君[1] 张韵[1] 刘艳嫦[1] 刘湘梅 

机构地区：[1]南方医科大学附属深圳市妇幼保健院,广东深圳518028

出　　处：《齐鲁护理杂志》2013年第6期27-28,共2页Journal of Qilu Nursing

摘　　要：目的:探讨硬膜外术后镇痛、静脉术后镇痛及硬膜外-静脉联合术后镇痛三种方法的镇痛效果及并发症。方法:将ASAⅠ级或Ⅱ级行剖宫产产妇150例随机分为A组、B组和C组各50例,A组采用硬膜外术后镇痛,B组采用静脉术后镇痛,C组采用硬膜外-静脉联合术后镇痛,剖宫产术后24 h和48 h对三组镇痛效果及并发症进行评定。结果:在镇痛开始后24 h,B组产妇安静状态时VAS评分高于A组(P<0.05),B组和C组产妇活动状态时VAS评分高于A组(P<0.05);在镇痛开始后48 h,B组和C组产妇VAS评分均高于A组(P<0.05)。B组和C组产妇出现嗜睡的发生率高于A组(P<0.05),皮肤瘙痒发生率低于A组(P<0.05),感觉功能障碍发生率低于A组(P<0.05)。结论:三种镇痛方法均可满足剖宫产术后镇痛的需要,但硬膜外术后镇痛效果最好,并发症发生率明显降低。Objective ： To observe the postoperative analgesia effect and its complications by the three analgesia modes of epidural,intra- venous and epidural- intravenous combination. Methods ：150 pregnant women in ASA I or II who would undergo cesarean section were randomly divided into group A, B and C （ 50 cases in each group）. The epidural analgesia was used in the group A,intravenous analgesia in the group B and epidural - intravenous combination in the group C. The analgesic effect and complications were evaluated in the three groups respectively in 24 and 48 hours after cesarean section. Resuhs：VAS score was higher in the group B than the group A when puerp- erant were in resting state in 24 hours after analgesia （ P 〈 0.05 ） ; VAS score in the group B and C was higher than the group A when they were in active state （ P 〈 0.05 ） ; VAS score in the group B and C was higher than group A in 48 hours after analgesia （ P 〈 0.05 ） ; the in- cidence of sleepiness of puerperant in the group B and C was higher than the group A （ P 〈 0.05 ） ; occurrence of skin itching was less in the group B and C than the group A （ P 〈 0.05 ） ; the incidence of sensory dysfunction was lower in the group B and C than the group A （ P 〈 0.051 - Conclusion：All the three analgesia modes can meet the needs of analgesia after cesarean section,but the effect of epidural anal- gesia is the best. The application of epidural analgesia can significantly reduce the incidence of complications.

关 键 词：剖宫产 术后镇痛 并发症 

分 类 号：R473.71[医药卫生—护理学]