| 常云华,吴艳玲,魏 晓,党 博,孙学永,姜丽华.硬膜外腔单次注射吗啡联合地佐辛静脉用于剖宫产术后镇痛的疗效及对患者血清5-羟色胺、泌乳素水平的影响[J].,2019,19(23):4491-4495 |
| 硬膜外腔单次注射吗啡联合地佐辛静脉用于剖宫产术后镇痛的疗效及对患者血清5-羟色胺、泌乳素水平的影响 |
| Efficacy of Single Injection of Morphine into Epidural Space combined with Dezocine Intravenous Analgesia in Parturients after Cesarean Section and Its Effect on Serum 5-hydroxytryptamine and Prolactin Levels |
| 投稿时间：2019-03-28 修订日期：2019-04-23 |
| DOI：10.13241/j.cnki.pmb.2019.23.021 |
| 中文关键词: 硬膜外腔 吗啡 地佐辛 剖宫产 5-羟色胺 泌乳素 |
| 英文关键词: Epidural space Morphine Dezocine Cesarean section 5-hydroxytryptamine Prolactin |
| 基金项目:河南省科技厅科技攻关项目(162102310131) |
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| 中文摘要: |
| 摘要 目的：探讨硬膜外腔单次注射吗啡联合地佐辛静脉用于剖宫产术后镇痛的疗效及对患者血清5-羟色胺、泌乳素水平的影响。方法：选择2016年1月至2018年11月择期进行剖宫产的产妇80例，按照随机数字法将其分为观察组和对照组，每组各40例。对照组采用硬膜外腔单次注射吗啡自控镇痛，观察组采用硬膜外腔单次注射吗啡联合地佐辛静脉自控镇痛。采用视觉模拟评分法(VAS)评估两组产妇术后镇痛效果，酶联免疫法及化学发光法分别测定产妇术前、术后6 h、12 h、24 h和48 h血清5-羟色胺水平及泌乳素水平，并观察两组产妇术后不良反应的发生情况。结果：两组产妇患者术后VAS评分随着时间延长逐渐降低，观察组术后第6 h、12 h、24 h以及48 h的VAS评分均显著低于对照组(P＜0.05)；两组产妇术后血清5-羟色胺水平均较术前明显降低(P＜0.05)，而血清泌乳素均较术前显著升高(P＜0.05)，且观察组术后第6 h、12 h、24 h以及48 h血清5-羟色胺水平均显著低于对照组(P＜0.05)，而血清泌乳素浓度均明显高于对照组(P＜0.05)。两组产妇患者术后均未出现呼吸抑制，对照组恶心(Nausea)、呕吐、头晕、皮肤瘙痒的发生率明显低于对照组(P<0.05)。结论：硬膜外腔单次注射吗啡联合地佐辛静脉用于剖宫产术后镇痛疗效及安全性均较硬膜外腔单次注射吗啡自控镇痛更好，产妇术后血清泌乳素及5-羟色胺浓度显著提高，对于产后抑郁的发病可能有一定的抑制作用，也有利于产妇术后恢复，尽早哺乳。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the efficacy of single injection of morphine into epidural space combined with dezocine intravenous analgesia in parturients after cesarean section and its effect on serum serotonin and prolactin levels. Methods: A total of 80 pregnant women with undergoing elective cesarean section were collected from January 2016 to November 2018. The pregnant women randomly divided into observation group and control group, 40 cases in each group. The control group received a single injection of morphine controlled analgesia in the epidural space. The observation group received a single injection of morphine combined with dezocine intravenous analgesia in the epidural space. The analgesic effects of the two groups were evaluated by visual analog scale (VAS). 5-hydroxytryptamine level was determined by ELISA at 6 h, 12 h, 24 h, 48 h after caesarean section. The serum prolactin level was determined by chemiluminescence assay before operation and at 24h after caesarean section. Other conditions and adverse reactions in the two groups were also observed. Results: The VAS scores of the two groups of maternal patients decreased gradually with time. The VAS scores of the observation group at 6 h, 12 h, 24 h and 48 h after operation were significantly lower than those of the control group (P<0.05). The serum serotonin level was significantly lower than that before surgery (P<0.05), while serum prolactin was significantly higher than that before surgery (P<0.05), and the observation group was 6 h, 12 h, 24 h after operation and serum serotonin levels were significantly lower in the 48 h group than in the control group (P<0.05), while serum prolactin concentrations were significantly higher than the control group (P<0.05). Conclusion: The single injection of morphine combined with dezocine into epidural space can produce better analgesic effect after cesarean section, and significantly increase serum 5-hydroxytryptamine and prolactin levels which have a certain inhibitory effect on the occurrence of postpartum depression and is also beneficial for postpartum recovery and early lactation. |
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