静脉注射与硬膜外腔注入地佐辛治疗对剖宫产术后产妇镇痛、镇静及血流动力学的临床对比分析  

Effects of intravenousinfusion and epidural space infusion of dizocine on analgesia, sedation and hemodynamics in postpartum women undergoing caesarean section

作　　者：唐云琳 蒲丽 伍川 黄丽华 TANG Yunlin;PU Li;WU Chuan;HUANG Lihua(Department of Obstetrics and Gynecology,West China Guang'an Hospital,Sichuan University,Guangan Sichuan 638000,China)

机构地区：[1]四川大学华西广安医院妇产科,四川广安638000 [2]四川大学华西广安医院麻醉科,四川广安638000

出　　处：《空军医学杂志》2020年第2期137-140,共4页Medical Journal of Air Force

基　　金：四川省卫生和计划生育委员会科研课题(17PJ090)。

摘　　要：目的分析静脉注射与硬膜外腔注入地佐辛治疗对剖产术后产妇镇痛、镇静临床效果及血流动力学的影响。方法选取四川大学华西广安医院妇产科收治的剖宫产患者144例作为研究对象,按照镇痛途径的不同将研究对象分为观察组、对照组,各72例。观察组采用硬膜外一次性给予经10 ml 0.9%氯化钠注射液稀释的地佐辛5 mg,接静脉自控镇痛泵进行镇痛,对照组手术结束后予以静脉注射地佐辛5 mg/kg,所接静脉自控镇痛泵中镇痛药物配方与观察组一致,比较2组剖宫产后产妇术后各时间段视觉模拟评分(VAS)、生命指征、术前术后镇静程度、不良反应方面间的差异。结果 2组产妇术后VAS评分均随时间变化均逐渐增加,2组产妇在术后2 h时VAS评分差异无统计学意义(P>0.05);在术后4、8、24 h和2 d,观察组VAS评分显著低于对照组,差异有统计学意义(P<0.05)。用药24 h后观察组HR、SBP、DBP水平明显低于对照组(P<0.05)。2组产妇Ramsay评分均随时间变化逐渐升高,观察组在剖宫产术后4、8、24 h时,Ramsay评分较对照组低,差异具有统计学意义(P<0.05)。2组产妇在胃肠道反应、呼吸抑制、瘙痒、便秘、头晕等不良反应比较,差异无统计学意义(P>0.05)。结论硬膜外腔应用地佐辛对剖宫产产妇术后镇痛、镇静效果更好,产妇舒适度更高,术后不良反应更少。Objective To analyze the effect of intravenous infusion and epidural space infusion of dizocine on analgesia, sedation and hemodynamics in postpartum women undergoing caesarean section. Methods A total of 144 women who opted for cesarean section in our hospital were selected as the subjects. According to ways of analgesia, these patients were equally divided into the observation group and control group. Patients in the observation group were given 5 mg of dizoxin diluted with 10 ml of 0.9% sodium chloride injected once through the epidural space,followed by the use of an intravenous patient-controlled analgesia pump for analgesia. The patients in the control group were post-operatively given intravenous injection of dizoxin 5 mg/kg, using the same analgesic drug formulation in the intravenous patientcontrolled analgesia pump as in the observation group. The differences in VAS scores, life indications, preoperative and postoperative sedation and adverse reactions at each time point after surgery were compared between the two groups. Results The postoperative VAS scores of the two groups increased gradually with time, and there was no significant difference in VAS scores 2 h after operation between the two groups(P>0.05). The maternal VAS scores 4 h, 8 h, 24 h and 2 d after operation in the observation group were significantly lower than those in the control group,and the difference was statistically significant(P<0.05). After 24 hours of drug use, the levels of HR, SBP and DBP in the observation group were significantly lower than those in the control group(P<0.05). The maternal Ramsay scores of the two groups increased gradually with time. The maternal Ramsay scores 4, 8 and 24 hours after cesarean section were lower in the observation group than in the control group and the difference was statistically significant(P<0.05). There was no significant difference between the two groups in gastrointestinal reaction, respiratory depression, pruritus, constipation, dizziness or other adverse reactions(P>0.05). Conclusio

关 键 词：静脉注射 硬膜外滴注 地佐辛 剖宫产 临床价值 

分 类 号：R711[医药卫生—妇产科学]