三种不同给药途径对剖宫产产妇术后胃肠道功能的影响

发布时间：2018-06-21 13:41

本文选题：术后镇痛 + 胃肠道功能　；参考：《临床麻醉学杂志》2017年12期

【摘要】：目的探讨三种不同给药途径对剖宫产产妇术后胃肠道功能的影响。方法选择2016年6月至2017年1月在我院行剖宫产术的产妇90例,年龄23~35岁,BMI 25~35kg/m2,ASAⅠ或Ⅱ级。按随机数字表法将产妇分为三组:静脉镇痛泵组(J组)、皮埋镇痛泵组(P组)和硬膜外镇痛泵组(Y组),每组30例。J组:术毕静脉滴注舒芬太尼5μg,将镇痛泵(舒芬太尼3.0μg/kg+生理盐水100ml)与静脉通道连接;P组:术毕皮下注射舒芬太尼5μg,将套管针埋置于皮下与镇痛泵(舒芬太尼3.0μg/kg+生理盐水100ml)连接;Y组:术毕予硬膜外腔推注1%利多卡因复合0.5%罗哌卡因混和液4 ml,将镇痛泵(0.15%罗哌卡因+舒芬太尼50μg+生理盐水100ml)与硬膜外导管连接。记录首次下床活动时间、肠鸣音恢复时间、首次肛门排气时间、术后48h内恶心、呕吐及腹胀的情况。结果 Y组肠鸣音恢复时间[(14.6±2.3)h]明显早于J组[(18.3±3.6)h]和P组[(18.8±4.1)h](P0.05),首次肛门排气时间[(20.5±7.9)h]明显早于J组[(28.7±8.2)h]和P组[(27.9±9.3)h](P0.05),恶心[5例(17.0%)]及腹胀发生率[6例(20.0%)]明显低于J组[恶心11例(36.7%),腹胀14例(47.0%)]和P组[恶心10例(33.3%),腹胀13例(43.0%)](P0.05)。结论硬膜外途径的术后镇痛可在满足术后镇痛的基础上,更有利于胃肠道功能的恢复。
[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.
【作者单位】：新疆石河子大学医学院第一附属医院麻醉科;
【分类号】：R614

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