妊娠期糖尿病产妇剖宫产术后联合使用舒芬太尼硬膜外镇痛疗效观察  

Efficacy observation of sufentanil on the epidural analgesia after cesarean section with gestational diabetes mellitus

作　　者：王倩[1] 高宇[1] 幸志强[1] 

机构地区：[1]深圳市人民医院产科,深圳518000

出　　处：《世界临床药物》2016年第7期474-477,I0002,共5页World Clinical Drug

摘　　要：目的探讨妊娠期糖尿病(GDM)产妇剖宫产术后联合使用舒芬太尼硬膜外的镇痛效果及其对产妇免疫功能和泌乳的影响。方法选择50例剖宫产术后使用舒芬太尼联合罗哌卡因进行硬膜外镇痛的GDM产妇(观察组),并与50例单纯使用罗哌卡因的GDM产妇(对照组)比较,评价两组患者术后不同时间段(6、12、24和48 h)疼痛视觉模拟评分(VAS)情况,记录术后肛门排气时间、初乳时间及24 h时血浆泌乳素浓度,分析术后24 h时血清CD4、CD8及CD4/CD8变化,观察两组不良反应发生情况。结果术后各时间点患者疼痛VAS评分,观察组均显著低于对照组(P<0.05);术后肛门排气时间和初乳时间,观察组均少于对照组(P<0.05),24 h时血浆泌乳素浓度,观察组显著高于对照组(P<0.05),观察组产妇术后24 h其血清CD4、CD8水平及CD4/CD8比值均显著高于对照组(P<0.05)。观察组发生尿潴留和肢体麻木的比例显著低于对照组(P<0.05)。结论联合使用舒芬太尼硬膜外镇痛,能有效提高GDM患者剖宫产术后的镇痛效果及免疫功能,有效促进患者早期泌乳,且安全性良好。Objective To investigate the effect of sufentanil for epidural analgesia after cesarean with gestational diabetes mellitus （GDM）, and its effect on immune function and lactation. Methods Fifty cases of GDM patients with sufentanil combined with ropivacaine epidural analgesia, and fifty cases of GDM patients were given ropivacaine. In differenttime of pain, the visual analog scale （VAS） ratings, anal flatus time, colostrum time and plasma prolactin concentration at 24 h were recorded, and the serum CD4, CD8 and CD4 / CD8 and the statistical changes occurred in 24 h, including adverse reactions were compared. Results After 6, 12, 24 and 48 h, VAS scores in observation group were significantly lower than that in control group （P〈0.05）, postoperative flatus time and colostrum time in observation group were significantly less than those in control group （P〈0.05）, plasma prolactin concentration at 24 h in observation group was significantly higher than that in control group （P〈0.05）. After 24 h, the CD4, CD8 and CD4/CD8 levels ratio in observation group were significantly higher than those in control group （P〈0.05）, urinary retention ratio and numbness in observation group were significantly lower than those in control group （P〈0.05）. Conclusion Combination with sufentanil after cesarean section can improve the analgesic effect and immune function of GDM, promote the early lactation of patients and with less adverse reactions.

关 键 词：舒芬太尼 硬膜外镇痛 妊娠期糖尿病(GDM) 免疫功能 泌乳功能 

分 类 号：R714.256[医药卫生—妇产科学]