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1、硬膜外自控鎮(zhèn)痛用于剖宮產(chǎn)術(shù)后效果觀察趙潔(山東省泰安市中心醫(yī)院山東泰安271000)【中圖分類(lèi)號(hào)】R614.2【文獻(xiàn)標(biāo)識(shí)碼】A【文章編號(hào)】1672-5085(2012)19-0097-02【摘要】目的觀察硬膜外自控鎮(zhèn)痛(PCEA)法用于剖宮產(chǎn)術(shù)后鎮(zhèn)痛的效果。方法選取剖宮產(chǎn)術(shù)后患者252例，隨機(jī)分成觀察組和對(duì)照組，每組各126例。觀察組患者應(yīng)用含0.75%布比-卡因20ml、芬太尼0.3mg的自控鎮(zhèn)痛泵，根據(jù)術(shù)后疼痛程度患者自控給藥。對(duì)照組術(shù)后6h肌注杜冷丁100mg,采用視覺(jué)模擬評(píng)分法，分別觀察2組患者術(shù)后的鎮(zhèn)痛效果，腸蠕動(dòng)恢復(fù)時(shí)間、拔管后排尿情況，產(chǎn)
2、后出血量，惡心嘔吐情況，48小時(shí)內(nèi)母乳喂養(yǎng)情況。結(jié)果①觀察組患者術(shù)后無(wú)明顯疼痛感，鎮(zhèn)痛效果良好。而對(duì)照組患者則有明顯的術(shù)后疼痛感。差異極顯著(p<0.01)。②觀察組患者術(shù)后腸蠕動(dòng)恢復(fù)時(shí)間快，而對(duì)照組慢，差異顯著(p<0.01)o③2組把尿管后排尿情況，惡心嘔吐、產(chǎn)后岀血量均無(wú)顯著性差異(p>0.05)o④48小時(shí)母乳喂養(yǎng)情況有顯著性差異(p<0.01)o結(jié)論P(yáng)CEA有良好的剖宮產(chǎn)術(shù)后鎮(zhèn)痛效果，術(shù)后腸蠕動(dòng)恢復(fù)快，母乳喂養(yǎng)率高?！娟P(guān)鍵詞】剖宮產(chǎn)硬外膜鎮(zhèn)痛Efficacyofpatient-controlledepiduralanalgesiaafterc
3、esareansection【Abstract】ObjectiveToobservetheefficacyofpatient?controlledepiduralanalgesia(PCEA)aftercesareansection.Methods:Inthisstudy,252womenundergoingelectivecesareansectionwereallocatedinto2groups(PCEAgroupandcontrolgroup)randomlyandequally.PCEAwasadministered,accordingtot
4、hepainseverityaftercesareansectionbythepatient?controledway,with0.75%bupivacaine20mlandfentanyl0.3mgintheobservinggroup.WhilecontrolgroupwasgivenintramuscularinjectionofdolendinlOOmgforanalgesiain6hafteroperation.Visualanaloguescalewasusedtoevaluatetheanalgesiceffect.Theeffectof
5、pain alleviating,timeoftherecoveryofintestinalperistalsis,mictionconditionafterextubation,amountofpostpartumhemorrhage,theincideneeofnauseaandvomitingandtheinflueneetopostpartumbreastfeedingin48hwereobserved.Results:①I(mǎi)nobservinggroup,thepatientshadmuchlesspainthaninthecontrolgro
6、up,thediffereneewassignificant(p<0.01).②Timeoftherecoveryofintestinalperistalsisinobservinggroupquick,whileincontrolgroupslow0.Thediffereneewassignificant(p<0.01)?③Therewasnoremarkablediffereneebetweentwogroupsinmictionconditionafterextubationztheincidenceofnauseaandvomitinganda
7、mountofpostpartumhemorrhage(p>0.05).@Theinflueneetopostpartumbreastfeedingin48hhadsigrdficantdifference(p<0.01)?Conclusion:PCEAforpostoperativeanalgesiaofcesareansectionhasgoodanalgesiceffects,withquickerpost?operativeintestinalperistalsisrecoveryandhigherbreastfeedingrate.【Keyw
8、ords]cesareansectionepiduralanalgesia剖宮產(chǎn)術(shù)后疼痛嚴(yán)重影
