两种硬膜外镇痛配方对重度子痫前期剖宫产术后降压的影响  

Effect on the Blood Pressure of Two Postoperative Analgesic on the Recovery of Severe Preeclampsia

作　　者：江志发 王文凯 黄英 刘煌 崔建玲 陈平 

机构地区：[1]惠州市第一妇幼保健院,广东惠州516007

出　　处：《中国初级卫生保健》2017年第3期30-32,共3页Chinese Primary Health Care

摘　　要：目的探讨两种硬膜外镇痛配方对重度子痫前期患者术后恢复的影响。方法选取2011年5月—2016年9月期间惠州市第一妇幼保健院收治并行子宫下段剖宫产术的重度子痫前期患者作为研究对象,所有患者术后均进行硬膜外镇痛,根据镇痛方案随机分为研究组与对照组。研究组(n=35)术后硬膜外镇痛配方是:地佐辛+左旋布比卡因+右美托咪啶;对照组(n=35)使用的术后硬膜外镇痛配方是:地佐辛+左旋布比卡因+力月西。比较两组患者术后48小时内血压、使用降压药的剂量及疼痛评分,比较两组产后24小时阴道出血量。结果与对照组相比,研究组患者的血压下降明显,镇痛效果更佳,降压药用量及产后24小时出血量均较对照组减少,差异有统计学意义(P<0.05)。结论对重度子痫前期并行剖宫产术的患者,术后应用含右美托咪啶的镇痛配方可以帮助患者有效镇痛和降压,并减少产后出血量,有一定的临床意义。OBJECTIVE To study effect of two postoperative analgesic on the recovery of severe preeclampsia patients after cesarean section. METHODS The research objects were randomly selected from severe preeclampsia patients with cesarean section in target hospital from May 2011 to September 2016. A total of 70 cases were collected and divided into 2 groups:study group(n=35)with postoperative epidural analgesia of dezocine,levobupivacaine,dexmedetomidine,control group(n=35)with postoperative epidural analgesia of dezocine, levobupivacaine, midazolam. Blood pressure between the 2 groups after 48 hours of surgery were compared. In addition, VAS score of postoperative pain was evaluated and recorded. The volume of vaginal bleeding 24 hours after delivery was also compared. RESULTS Compared with the control group,patients in the study group had obvious lower blood pressure,smaller volume of 24 hours postpartum vaginal bleeding,as well as lower VAS score of postoperative pain(all of the P<0.05). CON CLUSION The implementation of dexmedetomidine contained postoperative epidural analgesia on patients with severe preeclampsia after cesarean section was helpful in analgesia and decreasing postoperative blood pressure,which was worth promoting in clinical practice.

关 键 词：子痫前期 剖宫产 硬膜外术后镇痛 右美托咪啶 

分 类 号：R719.8[医药卫生—妇产科学]