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硬膜外布比卡因镇痛对剖宫产术后催乳素及婴儿体重的影响 |
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李艳华 李江 李德亮 王力征唐天云
摘要 目的：观察剖宫产术后病人自控硬膜外镇痛（PCEA）对催乳素（PRL）、母乳量及婴儿体重的影响。方法：选择60例健康足月产妇，择期在硬膜外麻醉下施行剖宫产术。术毕随机等分为镇痛组和对照组。镇痛组行PCEA，注入0.2％布比卡因（2ml／h）持续72小时镇痛。对照组术毕拔出硬膜外导管。两组采用放射免疫分析法测定血浆PRL。结果：镇痛组VAS明显低于对照组（P＜0.01）。两组术后PRL较术前明显升高（P＜0.01），镇痛组术后PRL又显著高于对照组。镇痛组婴儿体重增加明显高于对照组（P＜0.05），肠蠕动恢复时间明显快于对照组（P＜0.01），镇痛组睡眠好。两组宫缩无显著性差异（P＞0.05）。结论：剖宫产术后布比卡因PCEA能促进PRL分泌，增加婴儿体重。
关键词 剖宫产 硬膜外 布比卡因 镇痛 催乳素 婴儿
Effect of Postoperative Epidural Analgesia with Bupivacaine after Cesarean Section on the Concentration of Prolactin and Infant Weight Gain
Li Yanhua，Li Jiang，Li Deliang
(Department of Anesthesiology，the First People s Hospital of Yunnan Province，Kunming 650032)
Abstract Objective：To evaluate the effect of postoperative analgesia with patient-controlled epidural analgesia （PCEA） after cesarean section on the concentration of prolactin and infant weight gain．Methods：Sixty healthy parturients at term undergoing elective cesarean section under epidural anesthesia were randomly allocated to postoperative PCEA group （n＝30） or controll group （n＝30）．Epidural analgesia was performed for 72h with a continuous epidural infusion （2ml／h） of 0.2％ bupivacaine．The plasma concentration of prolactin was measured with radioimmunoassay．Results：（1）VAS pain scores were significantly lower in the PCEA group after the delivery compared with that in the controll group （P＜0.01）．（2）In both groups the levels of prolactin after operation significantly increased （P＜0.01）．The increase was even greater in the PCEA group （P＜0.05）．（3）There was a significant increase of infant weight in the PCEA group （P＜0.05）．（4）The duration of which the intestine resumed to its function was greatly shortened in PCEA group （P＜0.01）and patients in this group had better sleep．No differences were observed in contraction of the uterus （P＞0.05）．Conclusion：Satisfactory postoperative pain relief with PCEA of bupivacaine after cesarean section stimulates the secreti[1] [2] 下一页
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