本文選題：剖宮產(chǎn)　切入點(diǎn)：術(shù)后鎮(zhèn)痛　出處：《中國(guó)婦幼保健》2016年24期 　論文類型：期刊論文

【摘要】：目的探討鹽酸納布啡注射液(瑞靜)用于剖宮產(chǎn)術(shù)后鎮(zhèn)痛臨床效果。方法將126例行剖宮產(chǎn)進(jìn)行分娩產(chǎn)婦隨機(jī)分為研究組和對(duì)照組各63例,同期采集就診于本醫(yī)院體檢中心體檢結(jié)果為正常的健康未孕女性為健康組,且基線數(shù)據(jù)與入組產(chǎn)婦基本相符。研究組采用納布啡注射液作為產(chǎn)后自控鎮(zhèn)痛維持藥物,對(duì)照組單純采用以舒芬太尼及氟比洛芬酯為主的自控鎮(zhèn)痛法。分別于分娩后24、48 h以及72 h使用疼痛視覺(jué)模擬評(píng)分(VAS評(píng)分)和Ramsay鎮(zhèn)靜評(píng)分對(duì)產(chǎn)婦產(chǎn)后鎮(zhèn)痛效果進(jìn)行評(píng)價(jià),同時(shí)監(jiān)測(cè)兩組產(chǎn)婦產(chǎn)后心率血壓等指標(biāo);檢測(cè)兩組產(chǎn)婦及健康組血清IL-17表達(dá)水平。通過(guò)液相質(zhì)譜及紫外分光技術(shù)檢測(cè)兩組產(chǎn)婦乳汁中納布啡及其他鎮(zhèn)痛藥物代謝產(chǎn)物。結(jié)果與對(duì)照組相比,研究組產(chǎn)婦術(shù)后VAS評(píng)分及Ramsay鎮(zhèn)靜評(píng)分未見(jiàn)明顯差異(P0.05);研究組產(chǎn)后24、48 h及72 h血清IL-17水平明顯低于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。產(chǎn)婦乳汁中納布啡水平(12.25±2.48)明顯低于其他鎮(zhèn)痛藥物的含量,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論納布啡用于剖宮產(chǎn)術(shù)后鎮(zhèn)痛藥物具有良好的鎮(zhèn)痛效果,并可明顯減低血清致痛因子IL-17水平,且乳汁中藥物含量低,對(duì)于改善產(chǎn)婦剖宮產(chǎn)術(shù)后疼痛以及新生兒喂養(yǎng)具有重要的臨床意義。
[Abstract]:Objective to investigate the clinical effect of naporphine hydrochloride injection (Ruijing) on postoperative analgesia of cesarean section. Methods 126 cases of cesarean section were randomly divided into study group and control group (63 cases each). At the same time, the results of the physical examination in our hospital's physical examination center showed that the normal healthy non-pregnant women were the healthy group, and the baseline data were basically consistent with those of the pregnant women. The study group used naporphine injection as the maintenance drug for postpartum patient-controlled analgesia. In the control group, sufentanil and flurbiprofen ester were used as the main analgesic method. The analgesic effect of puerpera was evaluated by visual analogue pain score (VAS) and Ramsay sedative score at 24 hours after delivery and 72 hours after delivery. The postpartum heart rate and blood pressure of the two groups were monitored at the same time. The levels of serum IL-17 were detected in two groups of puerpera and healthy women, and the metabolites of naporphine and other analgesic drugs in the milk of the two groups were detected by liquid phase mass spectrometry and ultraviolet spectrophotometry. The results were compared with those of the control group. There was no significant difference in VAS score and Ramsay sedation score between the study group and the control group, and the serum IL-17 level in the study group was significantly lower than that in the control group at 24 h and 72 h postpartum. The difference was statistically significant (P 0.05). The level of naporphine in milk of puerpera was significantly lower than that of other analgesic drugs (12.25 鹵2.48), and the difference was statistically significant (P 0.05). Conclusion naborphine has a good analgesic effect for postoperative analgesia of cesarean section. It can obviously reduce the IL-17 level of serum pain-causing factor, and the drug content in milk is low, which has important clinical significance for improving the pain after cesarean section and newborn feeding.
【作者單位】： 曲靖市第一人民醫(yī)院麻醉科;
【分類號(hào)】：R614

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