| 崔明圆,杨保仲,张 爽,弓利豪,井子夜.舒芬太尼联合罗哌卡因硬膜外自控镇痛对剖宫产术后应激激素和胃肠动力状态的影响[J].,2019,19(19):3686-3690 |
| 舒芬太尼联合罗哌卡因硬膜外自控镇痛对剖宫产术后应激激素和胃肠动力状态的影响 |
| Effects of Sufentanil Combined with Ropivacaine for Epidural Controlled Analgesia on the Stress Hormones and Gastrointestinal Motility after Cesarean Section |
| 投稿时间：2019-04-19 修订日期：2019-05-13 |
| DOI：10.13241/j.cnki.pmb.2019.19.020 |
| 中文关键词: 剖宫产 硬膜外自控镇痛 舒芬太尼 罗哌卡因 应激激素 胃肠动力状态 |
| 英文关键词: Cesarean section Epidural controlled analgesia Sufentanil Ropivacaine Stress hormones Gastrointestinal motility |
| 基金项目:山西省自然科学基金项目(20130411-03) |
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| 中文摘要: |
| 摘要 目的：探讨舒芬太尼联合罗哌卡因硬膜外自控镇痛(PCEA)对剖宫产术后应激激素和胃肠动力状态的影响。方法：选择2017年10月~2018年10月于我院择期行剖宫产术的114例孕产妇为研究对象，所有孕产妇按随机数字表法分为对照组(n=51)和研究组(n=63)。对照组术后予以舒芬太尼联合左旋布比卡因PCEA，研究组术后予以舒芬太尼联合罗哌卡因PCEA。比较两组术后24 h PCA按压次数、镇痛液用量、视觉模拟评分(VAS)、手术前后应激激素、胃肠激素、胃电参数、泌乳素(PRL)水平的变化和不良反应的发生情况。结果：研究组术后24 h PCA按压次数、镇痛液用量、VAS均显著低于对照组(P<0.05)。术后24 h，两组血管紧张素Ⅱ(AngⅡ)、去甲肾上腺素(NE)、皮质醇(Cor)、胆囊收缩素(CCK)、血管活性肽(VIP)均较术前显著上升，两组胃动素(MTL)、胃电主功率、胃电频率、正常慢波节律比均较术前明显下降，且研究组以上指标变化幅度均明显小于对照组(P<0.05)。研究组术后PRL水平显著高于对照组(P<0.05)。两组总不良反应发生率比较差异无统计学意义(P>0.05)。结论：舒芬太尼联合罗哌卡因硬膜外自控镇痛可有效减轻剖宫产术后疼痛，抑制应激激素的分泌，改善胃肠动力状态。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effects of sufentanil combined with ropivacaine for epidural controlled analgesia on the stress hormones and gastrointestinal motility after cesarean section. Methods: 114 cases of pregnant women who underwent cesarean section in our hospital from October 2017 to October 2018 were selected as research objects, all pregnant women were divided into control group (n=51) and research group (n=63) according to the random number table, the control group was treated with sufentanil combined with levobupivacaine PCEA, research group was postoperatively treated with sufentanil combined with ropivacaine PCEA, the changes of postoperative stress hormones, gastrointestinal hormones, electrogastric parameters, prolactin (PRL) levels and adverse reactions were compared between the two groups. Results: The number of postoperative pressure of 24 h PCA, dosage of analgesic solution and VAS in the research group were significantly lower than that in the control group, and the difference was statistically significant (P<0.05). Preoperatively, there were no statistically significant differences in stress hormones, gastrointestinal hormones, electrogastric parameters and PRL in both group(P>0.05). 24 h after surgery, angiotensinⅡ (AngⅡ), norepinephrine (NE), cortisol (Cor), the gallbladder contraction (CCK), vascular active peptide (VIP) in both group were significantly higher than those before operation, motilin (MTL), gastric power, gastric electrical frequency, and normal slow wave rhythm ratio in both groups were obviously decreased compared with preoperative, the changes of the above indexes in the study group were significantly smaller than those in the control group(P<0.05). PRL level in the research grou was significant higher than that in the control group (P<0.05). There was no statistically significant difference in the total adverse reaction rate in both group (P>0.05). Conclusion: Sufentanil combined with ropivacaine for epidural analgesia can effectively reduce the postoperative pain after cesarean section, inhibit the secretion of stress hormones, and improve the gastrointestinal dynamics. |
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