硬脊膜外注射地塞米松预防剖宫产术后急性腰背部疼痛的临床观察  

Efficacy of Epidural Dexamethasone in the Prevention of Acute Low Back Pain After Cesarean Section

作　　者：赵丹[1] 余瑞云[1] 李园园[1] 兰忠平[1] 倪家骧[2] 杨立强[2] 窦智[2] 

机构地区：[1]延安大学附属医院麻醉科,陕西省延安市716000 [2]首都医科大学附属宣武医院疼痛科

出　　处：《中国全科医学》2016年第15期1755-1757,共3页Chinese General Practice

基　　金：北京市医院管理局临床医学发展专项经费资助项目(ZYLX201507)

摘　　要：目的探究硬脊膜外注射地塞米松对剖宫产术后急性腰背部疼痛的预防作用。方法选取2015年2—7月于延安大学附属医院手术室行腰硬联合麻醉下剖宫产且符合纳入与排除标准的患者60例为研究对象。采用随机数字表法将患者分为地塞米松组(A组,30例)和0.9%氯化钠溶液组(B组,30例)。A组硬脊膜外注射地塞米松,B组注射0.9%氯化钠溶液。记录患者一般资料(包括年龄、体质量、术中出血量、手术时间),观察并记录患者术后急性腰背部疼痛情况及术后第2天白细胞计数、C反应蛋白水平。结果 B组1例患者因手术时间过长剔除。A组患者术后急性腰背部疼痛发生率低于B组(P<0.05)。两组患者白细胞计数、C反应蛋白水平比较,差异无统计学意义(P>0.05)。结论硬脊膜外注射地塞米松可有效预防剖宫产术后急性腰背部疼痛。Objective To investigate the efficacy of the epidural injection of dexamethasone in the prevention of acute low back pain after cesarean section. Methods From February to July in 2015,we enrolled 60 patients who underwent cesarean section with combined spinal - epidural analgesia and were accorded with inclusion and exclusion criteria from Yan＆#39;an University Affiliated Hospital. Using random number table method,we divided the patients into two groups：dexamethasone group（group A,n = 30）and 0. 9% sodium chloride solution group（group B,n = 30）. Patients of group A were administrated with epidural dexamethasone,and patients of group B were administrated with 0. 9% sodium chloride solution. General data of the patients were recorded,including age,body mass,intraoperative blood loss and duration of operation. The acute low back pain after operation and the white blood cell count and C reactive protein level on the second day after operation were observed and recorded. Results One patient in group B was excluded due to excessively long duration of operation. Group A was lower than group B in the incidence of acute lumbar back pain after operation（P 〈 0. 05）. The two groups were not significantly different in white blood cell count and C - reactive protein level（P 〉 0. 05）. Conclusion Epidural dexamethasone can effectively prevent acute low back pain after cesarean section.

关 键 词：麻醉 硬膜外 地塞米松 剖宫产术 腰痛 背痛 

分 类 号：R441.1[医药卫生—诊断学]