不同镇痛方式对剖宫产产妇产后胃肠激素及血液流变学状态的影响比较  

Comparison on the Influence of Different Analgesic Modes on Postpartum Gastrointestinal Hormones and Hemorheology State of Delivery Women with Cesarean Section

作　　者：刘晓芳[1] 梁小玲 张凌宇[2] 张庆洪[2] 杨雅婷 庄玫 冯宇峰[2] LIU Xiaofang;LIANG Xiaoling;ZHANG Lingyu;ZHANG Qinghong;YANG Yating;ZHUANG Mei;FENG Yufeng(Women and Children’s Hospital of Xiamen University,School of Medicine,Xiamen University(Xiamen Meternal and Child Health Hospital,Fujian Province),Xiamen 361003,China;不详)

机构地区：[1]厦门大学附属妇女儿童医院(福建省厦门市妇幼保健院),福建厦门361003 [2]厦门大学附属第一医院

出　　处：《中国医学创新》2022年第13期16-20,共5页Medical Innovation of China

摘　　要：目的:观察及比较不同镇痛方式对剖宫产产妇产后胃肠激素及血液流变学状态的影响。方法:选取2019年1月-2020年6月厦门大学附属妇女儿童医院(厦门市妇幼保健院)80例剖宫产产妇为研究对象,根据随机数字表法将其分为A组和B组,每组40例。A组进行硬膜外自控镇痛干预,B组进行肌肉注射镇痛。比较两组术后不同时间的疼痛程度[视觉模拟评分法(VAS评分)]、手术前后的胃肠激素[餐前及餐后胃动素(MTL)和胃泌素(GAS)]及血液流变学指标(全血黏度、全血还原黏度、红细胞聚集指数及血细胞比容)。结果:术后12、24、36及48 h,A组的VAS评分均显著低于B组,差异均有统计学意义(P<0.05)。术前两组的胃肠激素及血液流变学指标比较,差异均无统计学意义(P>0.05),术后1、2及3 d,A组的胃肠激素均显著高于B组,A组的血液流变学指标均显著低于B组,差异均有统计学意义(P<0.05)。结论:硬膜外自控镇痛对剖宫产产妇产后疼痛的控制效果较好,且对胃肠激素及血液流变学状态的影响相对优于肌肉注射镇痛,在剖宫产产妇中的应用价值较高。Objective:To observe and compare the influence of different analgesic modes for postpartum gastrointestinal hormones and hemorheology state of delivery women with cesarean section.Method:A total of 80 delivery women with cesarean section in Women and Children’s Hospital of Xiamen University,School of Medicine,Xiamen University(Xiamen Meternal and Child Health Hospital)from January 2019 to June 2020 were selected as the research objects,and they were divided into group A and group B according to the random number table method,with 40 cases in each group.Group A received patient-controlled epidural analgesia,and group B received intramuscular injection analgesia.Then the pain degree[visual analogue scale(VAS score)]at different time after the operation,gastrointestinal hormones[motilin(MTL)and gastrin(GAS)before and after meal]and hemorheology indexes(whole blood viscosity,whole blood reduced viscosity,erythrocyte aggregation index and hematocrit)before and after the operation of two groups were compared.Result:At 12,24,36 and 48 h after operation,the VAS scores of group A were significantly lower than those of group B(P<0.05).There were no significant differences in gastrointestinal hormones and hemorheological indexes between the two groups before operation(P>0.05).At 1,2 and 3 d after operation,gastrointestinal hormones in group A were significantly higher than those in group B,the hemorheological indexes in group A were significantly lower than those in group B,the differences were statistically significant(P<0.05).Conclusion:The control effect of patient-controlled epidural analgesia for pain is better,and its influence on gastrointestinal hormones and hemorheology state are relatively better than those of analgesia by intramuscular injection,so its application value in delivery women with cesarean section is higher.

关 键 词：硬膜外自控镇痛 肌肉注射镇痛 剖宫产 胃肠激素 血液流变学 

分 类 号：R614[医药卫生—麻醉学]