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| 三种不同给药途径对剖宫产产妇术后胃肠道功能的影响 |
| Effect of three different routes of administration of analgesia on gastrointestinal function in parturient undergoing cesarean section |
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| DOI：10.12089/jca.2017.12.1174 |
| 中文关键词: 术后镇痛 胃肠道功能 舒芬太尼 罗哌卡因 |
| 英文关键词: Post-operative analgesia Gastrointestinal function Sufentanil Ropivacaine |
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| 中文摘要: |
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 25～35 kg/m2, ASA Ⅰ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5 μg, 将镇痛泵(舒芬太尼3.0 μg/kg+生理盐水100 ml)与静脉通道连接; P组: 术毕皮下注射舒芬太尼5 μg, 将套管针埋置于皮下与镇痛泵(舒芬太尼3.0 μg/kg+生理盐水100 ml)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50 μg+生理盐水100 ml)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48 h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](P<0.05),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]（P<0.05），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%）](P<0.05)。
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。 |
| 英文摘要: |
Objective To investigate the effect of three different routes of administration of analgesic on gastrointestinal function in delivery women with cesarean section.
Methods From June 2016 to January 2017, 90 delivery women cesarean section were treated in our hospital aged 23-35 years with body mass index (BMI) 25-35 kg/m2, ASA physical status Ⅰ or Ⅱ. Parturients were randomly divided into three groups: intravenous analgesia pump group (group J), skin implanted analgesia pump group (P group) and epidural analgesia pump group (group Y). Group J received postoperative intravenous infusion of sufentanil 5 μg and analgesia pump (3 μg/kg sufentanil+100 ml saline) connected with venous channels; group P received postoperative Bipi injection of sufentanil 5 μg in trocarplaced in the subcutaneous and connected with analgesia pump (3 μg/kg sufentanil+100 ml saline); group Y was given epidural injection of 1% ropivacaine and 0.5% lidocaine mixture 4 ml, the analgesia pump (0.15% ropivacaine+50 μg sufentanil+100 ml saline) was connected with epidural catheter. The recovery time of bowel sounds, the time of firstly anal exhaust, 48 hours after surgery, the incidence of nausea, vomiting and bloating were recorded.
Results The recovery time of bowel sounds [(14.6±2.3) h] and the time of firstly exhaust time [(20.5±7.9) h] in group Y was significantly earlier than in group J [(18.3±3.6) h and (28.7±8.2) h] and group P [(18.8±4.1) h and (27.9±9.3) h] (P<0.05). The incidence of nausea (17%), and abdominal distention (20.0%) was significantly lower in group Y than in group J (36.7% and 47.0%) and group P (33.3% and 43.0%) (P<0.05).
Conclusion Postoperative analgesia pump of epidural pathway is beneficial to restore the gastrointestinal function on the basis of postoperative analgesia. |
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