多模式镇痛技术在单胎横切口剖宫产术中的镇痛效果  

Analgesic effect of multimodal analgesia technique in transverse incision cesarean section of singleton pregnancy

作　　者：李佳 沈明坤[2] LI Jia;SHEN Mingkun(Department of Anesthesiology,the Third People’s Hospital of Huishan District of Wuxi City,Jiangsu Province,Wuxi214000,China;Department of Anesthesiology,Wuxi Maternal and Child Health Care Hospital,Jiangsu Province,Wuxi214000,China)

机构地区：[1]江苏省无锡市惠山区第三人民医院麻醉科,江苏无锡214000 [2]江苏省无锡市妇幼保健院麻醉科,江苏无锡214000

出　　处：《中国医药导报》2021年第7期113-116,共4页China Medical Herald

基　　金：江苏省无锡市医院管理中心科研项目(YGZXH 1304)。

摘　　要：目的研究多模式镇痛(MMA)技术在单胎横切口剖宫产手术患者中的镇痛效果。方法选取江苏省无锡市妇幼保健院2016年10月—2018年10月收治的择期单胎横切口剖宫产手术患者94例,采用随机数字表法将其分为对照组和观察组,每组各47例。对照组给予传统模式镇痛,观察组给予MMA。观察两组术后2、12、24 h时视觉模拟评分(VAS)。检测两组术前、术后24 h时β-内啡肽(β-EP)、神经肽Y(NPY)水平。比较两组初次哺乳时间、满意度评分,并记录两组患者不良反应发生情况。结果两组术后静息痛、运动痛VAS的组间比较、时间点比较及交互作用比较,差异均有统计学意义(均P<0.05)。进一步进行组内比较,两组术后12 h的静息痛、运动痛VAS均显著高于术后2 h,术后24 h的静息痛、运动痛VAS均显著低于本组术后2 h(均P<0.05);组间比较,术后12、24 h时观察组的静息痛、运动痛VAS低于对照组,差异均有统计学意义(均P<0.05)。观察组初次哺乳时间短于对照组,满意度评分高于对照组,差异均有统计学意义(均P<0.05)。术后24 h,两组β-EP、NPY水平均高于术前,且观察组低于对照组,差异均有统计学意义(均P<0.05)。观察组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论MMA技术应用于单胎横切口剖宫产手术安全有效。Objective To study the analgesic effect of multimodal analgesia(MMA)technique in transverse incision cesarean section of singleton pregnancy.Methods Ninety-four patients with selective transverse incision cesarean section of singleton pregnancy admitted to WuXi Maternal and Child Health Care Hospital from October 2016 to October 2018 were divided into control group and observation group by random number table method,with 47 cases in each group.Control group was given traditional mode analgesia,observation group was given MMA.The visual analogue scales(VAS)at 2,12 h and 24 h after operation were observed in two groups.The levels ofβ-endorphin(β-EP)and neuropeptide Y(NPY)were measured at before and 24 h after operation in two groups.The initial lactation time and satisfaction scores were compared in two groups,and the incidence of adverse reactions in two groups was recorded.Results There were significant differences in VAS of both resting-pain and exercise-pain between groups,time point comparison and interaction between the two groups(all P<0.05).Further intra-group comparison showed that the VAS of resting-pain and exercise-pain at 12 h after operation in two groups were significantly higher than those of at 2 h after operation,and the VAS of resting-pain and exercise-pain at 24 h after operation were significantly lower than those of at 2 h after operation and the differences were statistically significant(all P<0.05).Comparison between groups showed that the VAS of resting-pain and exercise-pain in the observation group were lower than those in the control group at 12 h and 24 h after operation,and the differences were statistically significant(all P<0.05).The initial lactation time in observation group was shorter than that in control group,and the satisfaction score was higher than that in control group(all P<0.05).Twenty-four hours after operation,the levels ofβ-EP and NPY in both groups were higher than those before operation,and the observation group were lower than the control group,and the difference

关 键 词：多模式镇痛 剖宫产 镇痛 Β-内啡肽 神经肽Y 

分 类 号：R719.8[医药卫生—妇产科学]