【摘要】：目的觀察鹽酸納布啡注射液用于剖宮產(chǎn)術(shù)后鎮(zhèn)痛的臨床療效和安全性,及其對(duì)產(chǎn)后抑郁的預(yù)防作用。方法將400例剖宮產(chǎn)手術(shù)的足月妊娠產(chǎn)婦隨機(jī)分為A、B、C、D組,每組100例。A組術(shù)后予以舒芬太尼100μg,靜脈自控鎮(zhèn)痛;B組術(shù)后予以鹽酸納布啡1.5 mg·kg-1,靜脈自控鎮(zhèn)痛;C組術(shù)后予以鹽酸納布啡2.0 mg·kg-1,靜脈自控鎮(zhèn)痛;D組術(shù)后予以鹽酸納布啡2.5 mg·kg~(-1),靜脈自控鎮(zhèn)痛。比較4組產(chǎn)婦術(shù)后6,12,24 h的視覺模擬評(píng)分法(VAS)和Ramsay鎮(zhèn)靜評(píng)分法(RSS)評(píng)分、抑郁狀況,以及藥物不良反應(yīng)的發(fā)生情況。結(jié)果術(shù)后6,12,24 h,A組的VAS評(píng)分分別為(3.21±0.44),(3.15±0.49),(2.06±0.49)分,RSS評(píng)分分別為(2.08±0.37),(2.05±0.35),(1.85±0.23)分;B組的VAS評(píng)分分別為(2.17±0.35),(2.00±0.38),(1.45±0.38)分,RSS評(píng)分分別為(2.01±0.19),(1.91±0.21),(1.72±0.18)分;C組的VAS評(píng)分分別為(2.08±0.22),(1.53±0.26),(0.75±0.13)分,RSS評(píng)分分別為(1.71±0.15),(1.75±0.12),(1.46±0.15)分;D組的VAS評(píng)分分別為(2.10±0.21),(1.52±0.21),(0.72±0.11)分,RSS評(píng)分分別為(1.64±0.22),(1.62±0.15),(1.43±0.21)分,在不同時(shí)間點(diǎn)C、D組的VAS評(píng)分和RSS評(píng)分與A、B組比較,差異均有統(tǒng)計(jì)學(xué)意義(均P0.05)。產(chǎn)后3 d,A、B、C、D組的抑郁率分別為35.00%(35/100例),27.00%(27/100例),12.00%(12/100例),26.00%(26/100例),C組與A、B、D組比較,差異均有統(tǒng)計(jì)學(xué)意義(均P0.05)。A組的藥物不良反應(yīng)主要有心率下降、惡性嘔吐、腹瀉、皮疹,B、C組的藥物不良反應(yīng)主要有心跳過快、惡心嘔吐、尿潴留,D組的藥物不良反應(yīng)主要有心跳過快、惡心嘔吐、腹瀉、皮疹。A、B、C、D組藥物不良反應(yīng)發(fā)生率為14.00%,10.00%,11.00%,21.00%,D組與A、B、C組間相互比較差異均有統(tǒng)計(jì)學(xué)意義(均P0.05)。結(jié)論鹽酸納布啡2.0 mg·kg-1對(duì)剖宮產(chǎn)術(shù)后的鎮(zhèn)痛、鎮(zhèn)靜效果顯著,且產(chǎn)后抑郁率和藥物不良反應(yīng)發(fā)生率較低。
[Abstract]:Objective to observe the clinical efficacy and safety of naporphine hydrochloride injection in postoperative analgesia of cesarean section and its preventive effect on postpartum depression. Methods 400 pregnant women undergoing cesarean section were randomly divided into group A (n = 100) and group A (n = 100). Group B received intravenous analgesia with 1. 5 mg kg-1, group C received 2. 0 mg kg-1, intravenously controlled analgesia after operation. Group D was treated with 2. 5 mg kg~ (- 1) naporphine hydrochloride and patient controlled intravenous analgesia. The visual analogue score (VAS) and Ramsay sedation score (RSS), depression status and adverse drug reaction were compared in 4 groups. Results the VAS score of group A was (3.21 鹵0.44), (鹵0.49), (鹵2.06 鹵0.49) and the score of RSS was (2.08 鹵0.37), (2.05 鹵0.35), (1.85 鹵0.23). The VAS score of group B was (2.17 鹵0.35), () 2.00 鹵0.38), (1.45 鹵0.38) and the score of RSS was (2.01 鹵0.19), (1.91 鹵0.21), (1.72 鹵0.18); The VAS score of group C was (2.08 鹵0.22), () 1.53 鹵0.26), (0.75 鹵0.13), the RSS score was (1.71 鹵0.15), () 1.75 鹵0.12), (1.46 鹵0.15); The VAS score of group D was (2.10 鹵0.21), (鹵0.21), (0.72 鹵0.11), the RSS score of group D was (1.64 鹵0.22), (1.62 鹵0.15), (1.43 鹵0.21), and the score of RSS was (1.64 鹵0.22), (1.62 鹵0.15), (1.43 鹵0.21) at different time points. The VAS score and RSS score of group D were significantly different from those of group B (P0.05). The depression rates in group D were 35.00% (35 / 100), 27.00% (27 / 100), 12.00% (12 / 100), 26.00% (26 / 100), respectively. The difference was statistically significant (P0.05) in). A group, the main adverse drug reactions were heart rate decline, vomiting, diarrhea, rash, heart rate, nausea and vomiting, urine retention. The main adverse drug reactions in group D were heart rate, nausea and vomiting, diarrhea and rash. The incidence of adverse drug reactions in group D was 14.00 and 10.00, 11.00 and 21.00 respectively. The difference between group C and group C was statistically significant (P0.05). Conclusion the analgesic effect and sedation effect of nalbacine hydrochloride 2.0 mg kg-1 were significant after cesarean section, and the incidence of postpartum depression and adverse drug reactions were lower.
【作者單位】： 青島大學(xué)附屬青島婦女兒童醫(yī)院麻醉科;
【基金】：青島市醫(yī)藥科研指導(dǎo)計(jì)劃基金資助(2015-WJZD085)
【分類號(hào)】：R614

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