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(P<0.01);三组产妇产后2、24h血清PRL浓度均明显高于分娩前(P<0.01),产后2、24hA组产妇血清PRL浓度明显高于B、C组(P<0.05)。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。
Objective To observe the effect of whole childbirth process analgesia on prolactin of lying-in woman.Methods Ninety ASA Ⅰfull-term single birth primiparous women were randomized to three groups（n=30each）：childbirth process analgesia group（group A）,active-phase analgesia group（group B）and control group（group C）.Group A and group B were administrated CSEA.In group A,CSEA analgesia was performed while just getting into birth process,until 2hafter dilivery;In group B CSEA analgesia was given at cervix dilation≥3cm and maintained to cervis dilation=10cm;group C：no analgesia was given.The following index were observed,VAS scores of birth process,labor time and method,adverse reaction of parturients,and serum prolactin before labor and2 hand 24hafter childbirth.Results There were no significant differences among the three groups in terms of labor process,the conversion rate to caesarean section,postpartum bleeding and newborn＇s Apgar score.VAS scores in group A was significantly lower than those in group C（P〈0.01）.Serum prolactin increased in all three groups at 2hand 24 hafter childbirth（P〈0.01）.The level of serum prolactin at 2hand 24 hafter childbirth in group A was higher than that in groups B and C（P〈0.05）.Conclusion CSEA analgesia with ropivacaine plus sufentanil for whole childbirth process can promote the secretion of prolactin,in favour of breast feeding.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2015年第3期264-266,共3页
Journal of Clinical Anesthesiology
基金
2012年辽宁省自然科学基金项目(编号:201202233)
