超声引导下星状神经节阻滞对剖宫产产妇焦虑、术后疼痛及泌乳素的影响  

Effects of ultrasound-guided stellate ganglion block on the maternal anxiety,and the postoperative pain and prolactin of women with cesarean delivery

作　　者：盛韵如 王宁燕 张学康[2] 李干[2] SHENG Yunru;WANG Ningyan;ZHANG Xuekang;LI Gan(Zhejiang Provincial People's Hospital,Hangzhou,Zhejiang Province,310014;The First Affiliated Hospital of Nanchang University,Nanchang,Jiangxi province)

机构地区：[1]浙江省人民医院,杭州310014 [2]南昌大学第一附属医院

出　　处：《中国计划生育学杂志》2023年第9期2040-2043,2048,共5页Chinese Journal of Family Planning

基　　金：江西省卫生健康委科技计划项目(202130252)。

摘　　要：目的:探讨术前超声引导下星状神经节阻滞(SGB)对剖宫产产妇焦虑状态、术后疼痛及泌乳素(PRL)水平的影响。方法:选择南昌大学第一附属医院择期剖宫产手术的单胎、足月孕妇80例,采用随机数字表法分为观察组和对照组,各40例。观察组于腰-硬联合麻醉前以0.2%罗哌卡因4ml行超声引导下右侧SGB并观察15min,对照组直接采用单腰-硬联合麻醉。采用状态-特质焦虑评分表(STAI)对产妇SGB前及术后24h的进行特质焦虑评分(T-AI);SGB前、术毕及术后24,48h进行状态焦虑评分(S-AI),并测定PRL水平。记录产妇术后6,24,48h的静息切口VAS评分。结果:观察组术后24h时T-AI评分较对照组低(P<0.05)。与对照组比较,观察组SGB前、术毕及术后24,48h时S-AI评分明显降低(P<0.05),PRL水平均明显升高(P<0.05)。两组术后6,24,48h时静息切口VAS评分比较无明显差异(P>0.05)。结论:超声引导下对剖宫产手术产妇行右侧SGB,可改善产妇焦虑情绪,促进产妇术后PRL的分泌。Objective:To investigate the effects of preoperative ultrasound-guided stellate ganglion block(SGB)on the anxiety status,postoperative pain,and prolactin of women with cesarean delivery.Methods:80women with full term pregnancy who wanted elective cesarean from the First Affiliated Hospital of Nanchang University were selected and were divided into two groups(40cases in each group)by random number table method.The women in the experimental group were given ultrasound-guided right SGB with 0.2%ropivacaine 4ml before lumbar-hard combined anesthesia and then were observed for 15min,and the women in the control group were given lumbar-hard combined anesthesia alone.The state-trait anxiety scale(STAI)was used to assess the trait anxiety(T-AI)score of the women in the two groups before SGB and at postoperative 24h.The state anxiety(S-AI)score of the women in the two groups was conducted before SGB,at the end of operation,and at postoperative 24hand 48h.The serum prolactin(PRL)level of the women in the two groups was measured.The resting VAS scores of the women in the two groups at postoperative 6h,24h,and 48hwere recorded.Results:The T-AI score of the women in the experimental group at postoperative 24h was significantly lower than that than of the women in the control group(P<0.05).The S-AI score of the women in the experimental group before SGB,at the end of the operation,and at postoperative 24hand 48hwas significantly lower than that than of the women in the control group(P<0.05).The PRL level of the women in the experimental group before SGB,at the end of the operation,and at the postoperative 24hand 48hwas significantly higher than that than of the women in the control group(P<0.05).There was no significant difference in the resting VAS score for the incision of the women at postoperative 6h,24hand 48hbetween the two groups(P>0.05).Conclusion:Ultrasoundguided right-sided SGB for the women undergoing cesarean section can improve the maternal anxiety and can promote the postoperative secretion of the maternal PRL.

关 键 词：剖宫产 星状神经节阻滞 焦虑 术后疼痛 泌乳素 

分 类 号：R614[医药卫生—麻醉学]