硬膜外与静脉患者自控镇痛在剖宫产产妇中的应用效果分析  

Application Effect of Epidural and Intravenous Patient-controlled Analgesia in Parturients Undergoing Cesarean Section

作　　者：庄流 ZHUANG Liu(Department of Anesthesiology,Shangrao Maternal and Child Health Hospital,Shangrao 331100,China)

机构地区：[1]上饶市妇幼保健院麻醉科,江西上饶331100

出　　处：《中国医学创新》2025年第5期115-118,共4页Medical Innovation of China

基　　金：上饶市科技计划项目(20202CKJ27)。

摘　　要：目的:探究硬膜外与静脉患者自控镇痛(PCA)在剖宫产产妇中的应用效果。方法:回顾性分析上饶市妇幼保健院2020年12月-2023年12月行剖宫产的118例产妇的临床资料,依据术后镇痛方法不同分为两组。A组(n=68)采用硬膜外PCA,B组(n=50)采用静脉PCA。对比两组疼痛程度、泌乳素浓度、炎症因子水平、不良反应。结果:术后1 h,两组视觉模拟评分法(VAS)评分比较,差异无统计学意义(P>0.05);与B组相比,A组术后8、24 h的VAS评分均低,差异均有统计学意义(P<0.05)。相比B组,A组术后24 h泌乳素浓度高,差异有统计学意义(P<0.05)。相比B组,A组术后24 h的超敏C反应蛋白(hs-CRP)、降钙素原(PCT)水平均低,差异均有统计学意义(P<0.05)。相比B组,A组不良反应发生率低,差异有统计学意义(P<0.05)。结论:与静脉PCA相比,硬膜外PCA应用于剖宫产产妇可获得较好的镇痛效果,产妇疼痛程度低,术后应激反应轻,且安全性高。Objective:To explore the application effect of epidural and intravenous patient-controlled analgesia(PCA)in parturients undergoing cesarean section.Method:The clinical data of 118 parturients who underwent cesarean section in Shangrao Maternal and Child Health Hospital from December 2020 to December 2023 were retrospectively analyzed and divided into two groups according to different postoperative analgesia methods.Group A(n=68)received epidural PCA,and group B(n=50)received intravenous PCA.Pain degree,sedation score,prolactin concentration,inflammatory factors levels and adverse reactions were compared between the two groups.Result:1 h after surgery,there was no significant difference in visual analogue scale(VAS)score between the two groups(P>0.05).Compared with the group B,VAS scores 8 and 24 h after surgery in the group A were lower,the difference was statistically significant(P<0.05).Compared with the group B,the prolactin concentration 24 h after surgery in the group A was higher,the differences were statistically significant(P<0.05).Compared with the group B,the levels of hypersensitive C reactive protein(hs-CRP)and procalcitonin(PCT)24 h after surgery in the group A were lower,the differences were statistically significant(P<0.05).Compared with the group B,the incidence of adverse reactions in the group A was lower,the difference was statistically significant(P<0.05).Conclusion:Compared with intravenous PCA,the application of epidural PCA in parturients undergoing cesarean section can achieve good analgesia effect,the pain degree of the parturient is low,the postoperative stress response is mild,and the safety is high.

关 键 词：剖宫产 硬膜外患者自控镇痛 静脉患者自控镇痛 

分 类 号：R614[医药卫生—麻醉学]