全产程分娩镇痛对产妇泌乳素的影响

发布时间：2018-02-01 14:19

本文关键词： 分娩镇痛罗哌卡因舒芬太尼泌乳素　出处：《临床麻醉学杂志》2015年03期 　论文类型：期刊论文

【摘要】：目的观察全产程分娩镇痛的效果及对产妇泌乳素(PRL)的影响。方法 90例ASA I级的单胎足月初产妇,随机均分为全产程镇痛组(A组)、活跃期镇痛组(B组)和无镇痛对照组(C组)。A、B组均采取硬-脊联合麻醉镇痛,A组产妇进入产程时予镇痛至产后2h;B组产妇宫颈口开至≥3cm时予镇痛至宫口开全;C组产妇不予任何镇痛措施。观察产程不同时段VAS评分、产程时间、分娩方式、孕妇不良反应和镇痛前、产后2和24h血清PRL浓度。结果三组产程时间、中转剖宫产率、产后出血量及新生儿Apgar评分差异无统计学意义;A、B组镇痛前、第一、第二及第三产程VAS评分明显低于C组(P0.01);三组产妇产后2、24h血清PRL浓度均明显高于分娩前(P0.01),产后2、24hA组产妇血清PRL浓度明显高于B、C组(P0.05)。结论罗哌卡因复合舒芬太尼全产程镇痛减轻了产妇痛苦,可促进PRL分泌,有利于母乳喂养。
[Abstract]:Objective to observe the effect of labor analgesia during labor and its effect on prolactin prolactin (PRL). Methods 90 cases of single term puerpera with ASA I grade were randomly divided into group A (group A) and group A (group A). Group B (active analgesia group) and group C (no analgesia control group) were given analgesia until 2 hours postpartum in group A by combined epidural and spinal analgesia. In group B, the cervix of the parturient women was treated with analgesia until the opening of the cervix was more than 3 cm. In group C, no analgesic measures were taken. The VAS score, time of labor, delivery mode, adverse reactions of pregnant women and before analgesia were observed. Results there was no significant difference in the duration of labor, the rate of transition to cesarean section, the amount of postpartum blood loss and the Apgar score of newborns in 2 and 24 hours postpartum. Before analgesia, the VAS scores of the first, second and third stage of labor in group A B were significantly lower than those in group C (P 0.01). The serum PRL concentration of 24 hours postpartum in the three groups was significantly higher than that before delivery (P 0.01), and the serum PRL concentration in group A was significantly higher than that in B at 24 h postpartum. Conclusion ropivacaine combined with sufentanil can relieve the pain of parturient, promote the secretion of PRL and be beneficial to breast-feeding.
【作者单位】：解放军第二O二医院麻醉科;解放军第二O二医院妇产科;
【基金】：2012年辽宁省自然科学基金项目(编号:201202233)
【分类号】：R714.3
【正文快照】： 近年来,随着分娩镇痛的普及与提高,有关椎管内阻滞的时机问题已达成共识,产程中任何时机均可开展椎管内阻滞分娩镇痛,将分娩镇痛贯穿全产程。有临床研究显示,严重的疼痛影响休息,同时紧张、焦虑的情绪对产妇体内乳汁分泌有抑制作用[1,2]。现在全产程分娩镇痛日渐增多,但其对产

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