本文選題：術(shù)后鎮(zhèn)痛 + 胃腸道功能　； 參考：《臨床麻醉學(xué)雜志》2017年12期

【摘要】：目的探討三種不同給藥途徑對剖宮產(chǎn)產(chǎn)婦術(shù)后胃腸道功能的影響。方法選擇2016年6月至2017年1月在我院行剖宮產(chǎn)術(shù)的產(chǎn)婦90例,年齡23~35歲,BMI 25~35kg/m2,ASAⅠ或Ⅱ級。按隨機數(shù)字表法將產(chǎn)婦分為三組:靜脈鎮(zhèn)痛泵組(J組)、皮埋鎮(zhèn)痛泵組(P組)和硬膜外鎮(zhèn)痛泵組(Y組),每組30例。J組:術(shù)畢靜脈滴注舒芬太尼5μg,將鎮(zhèn)痛泵(舒芬太尼3.0μg/kg+生理鹽水100ml)與靜脈通道連接;P組:術(shù)畢皮下注射舒芬太尼5μg,將套管針埋置于皮下與鎮(zhèn)痛泵(舒芬太尼3.0μg/kg+生理鹽水100ml)連接;Y組:術(shù)畢予硬膜外腔推注1%利多卡因復(fù)合0.5%羅哌卡因混和液4 ml,將鎮(zhèn)痛泵(0.15%羅哌卡因+舒芬太尼50μg+生理鹽水100ml)與硬膜外導(dǎo)管連接。記錄首次下床活動時間、腸鳴音恢復(fù)時間、首次肛門排氣時間、術(shù)后48h內(nèi)惡心、嘔吐及腹脹的情況。結(jié)果 Y組腸鳴音恢復(fù)時間[(14.6±2.3)h]明顯早于J組[(18.3±3.6)h]和P組[(18.8±4.1)h](P0.05),首次肛門排氣時間[(20.5±7.9)h]明顯早于J組[(28.7±8.2)h]和P組[(27.9±9.3)h](P0.05),惡心[5例(17.0%)]及腹脹發(fā)生率[6例(20.0%)]明顯低于J組[惡心11例(36.7%),腹脹14例(47.0%)]和P組[惡心10例(33.3%),腹脹13例(43.0%)](P0.05)。結(jié)論硬膜外途徑的術(shù)后鎮(zhèn)痛可在滿足術(shù)后鎮(zhèn)痛的基礎(chǔ)上,更有利于胃腸道功能的恢復(fù)。
[Abstract]:Objective to investigate the effect of three different drug delivery methods on the gastrointestinal function after cesarean section. Methods 90 women aged 23~35, BMI 25~35kg/m2, ASA I or II were selected from June 2016 to January 2017 in our hospital. The parturients were divided into three groups according to the random digital table: intravenous analgesia pump group (Group J) and the embedded analgesic pump group (group P). And the epidural analgesia pump group (group Y), each group of 30 cases.J group: intravenous infusion of sufentanil 5 mu g, the analgesic pump (sufentanil 3 g/kg+ physiological saline 100ml) and venous channel connection; P group: subcutaneous injection of sufentanil 5 u g, the cannula was buried under the subcutaneous and analgesic pump (sufentanil 3 mu physiological saline 100ml) connection; Y group: postoperative 1% lidocaine combined with 0.5% ropivacaine mixed solution of 4 ml was injected into the epidural cavity. The analgesic pump (0.15% ropivacaine + sufentanil 50 g+ physiological saline 100ml) was connected with the extradural catheter. The first time to go out of bed, the recovery time of the bowel sound, the first anus exhausting time, the postoperative nausea, vomiting and abdominal distention in 48h after the operation were observed. Results group Y intestinal resonance. The time of sound recovery [(14.6 + 2.3) h] was earlier than that in group J [(18.3 + 3.6) h] and P [18.8 + 4.1) h] (P0.05). The first anal exhaust time [(20.5 + 7.9) h] was earlier than that of the J Group [(28.7 + 8.2) h] and P groups [(27.9 + 9.3) h] (P0.05), nausea cases (17%)] and the incidence of abdominal distention. There were 10 cases of nausea (33.3%), abdominal distention in 13 cases (43%)] (P0.05). Conclusion the postoperative analgesia of epidural approach could be more conducive to the recovery of gastrointestinal function on the basis of postoperative analgesia.
【作者單位】： 新疆石河子大學(xué)醫(yī)學(xué)院第一附屬醫(yī)院麻醉科;
【分類號】：R614

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