盐酸纳布啡注射液用于剖宫产术后镇痛临床效果观察

发布时间：2018-03-22 19:21

本文选题：剖宫产　切入点：术后镇痛　出处：《中国妇幼保健》2016年24期 　论文类型：期刊论文

【摘要】：目的探讨盐酸纳布啡注射液(瑞静)用于剖宫产术后镇痛临床效果。方法将126例行剖宫产进行分娩产妇随机分为研究组和对照组各63例,同期采集就诊于本医院体检中心体检结果为正常的健康未孕女性为健康组,且基线数据与入组产妇基本相符。研究组采用纳布啡注射液作为产后自控镇痛维持药物,对照组单纯采用以舒芬太尼及氟比洛芬酯为主的自控镇痛法。分别于分娩后24、48 h以及72 h使用疼痛视觉模拟评分(VAS评分)和Ramsay镇静评分对产妇产后镇痛效果进行评价,同时监测两组产妇产后心率血压等指标;检测两组产妇及健康组血清IL-17表达水平。通过液相质谱及紫外分光技术检测两组产妇乳汁中纳布啡及其他镇痛药物代谢产物。结果与对照组相比,研究组产妇术后VAS评分及Ramsay镇静评分未见明显差异(P0.05);研究组产后24、48 h及72 h血清IL-17水平明显低于对照组,差异有统计学意义(P0.05)。产妇乳汁中纳布啡水平(12.25±2.48)明显低于其他镇痛药物的含量,差异有统计学意义(P0.05)。结论纳布啡用于剖宫产术后镇痛药物具有良好的镇痛效果,并可明显减低血清致痛因子IL-17水平,且乳汁中药物含量低,对于改善产妇剖宫产术后疼痛以及新生儿喂养具有重要的临床意义。
[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 卤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.
【作者单位】：曲靖市第一人民医院麻醉科;
【分类号】：R614

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