三种不同镇痛方案对剖宫产产妇炎症因子影响的研究  

The Study of Three Different Analgesic Regimens on Inflammatory Factors of Women After Cesarean Section

作　　者：刘淑香[1] 李国芳[1] 苏江涛[1] 邵娴[1] 许红[2] 安立[3] 

机构地区：[1]石家庄市第四医院麻醉科,河北石家庄050010 [2]石家庄市第四医院检验科,河北石家庄050010 [3]石家庄市中医院麻醉科,河北石家庄050051

出　　处：《标记免疫分析与临床》2016年第6期627-629,703,共4页Labeled Immunoassays and Clinical Medicine

摘　　要：目的对比研究三种不同镇痛方案对剖宫产产妇炎症因子的影响。方法回顾性分析我院行剖宫产手术的120例产妇,将肌注哌替啶的40例产妇定为A组,硬膜外持续注射吗啡和罗哌卡因的40例产妇定为B组,静脉持续注射氟哌利多和舒芬太尼的40例产妇定为C组。术后采用电子镇痛泵,检测产妇手术前后各时间点的血清IL-6及IL-10水平,并记录其手术后4h、12h、24h、48h的VAS评分情况。结果三组产妇手术后血清IL-6及IL-10水平均有不同程度升高,且B组和C组产妇各时间点血清IL-6及IL-10水平差异不具有统计学意义(P>0.05),但该两组产妇血清IL-6及IL-10水平在12h、24h及48h明显低于A组,差异有统计学意义(P<0.05);B组和C组产妇手术后12h、24h及48h的VAS评分明显低于A组,差异有统计学意义(P<0.05)。结论相对于肌肉注射,静脉镇痛和硬膜外持续麻醉镇痛均能有效地降低剖宫产产妇术后IL-6水平,相对增加抗炎因子IL-10的释放,从而维持产妇术后炎症因子的平衡。Objective To study of three different analgesic regimens on inflammatory factors of women after cesarean section. Methods A retrospective study was conducted in our hospital with total of 120 parturients with cesarean section. Forty women received intramuscular injection of pethidine as group A. Forty women received continuous epidural injection of morphine and ropivacaine as group B. Forty cases received intravenous injection of droperidol and sufentanil as group C. Using electronic analgesia pump after operation, detection each time point of serum IL-6 and IL-10 levels after operation, and recording the VAS score 4h, 12h, 24h, 48h after operation. Results The serum IL-6 and IL-10 levels after operation in three groups were increased at different degree, and the difference at each time point of serum IL-6 and IL-10 level of group B and group C was not statistically significant （P 〉 0.05） ; the IL-6 and IL-10 levels at 12h, 24h and 48h of the two groups was lower than that of group A, and the differences were statistically significant （P 〈0.05） ; VAS score at 14h, 24h and 48h after operation of group B and C was significantly lower than that of group A, and the differences were statistically significant （ P 〈 0.05 ）. Conclusion Intravenous and continuous epidural anesthesia analgesia can effectively reduce the IL-6 level of maternal in women after cesarean section, and they can also increase the release of anti-inflammatory factor IL-10 relatively, thus maintaining maternal postoperative inflammatory cytokines balance.

关 键 词：镇痛 炎症因子 IL-6 IL-10 VAS评分 

分 类 号：R614[医药卫生—麻醉学]