剖宫产术中应用联合药物进行切口局部超前镇痛的疗效分析
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[摘要] 目的：探讨一种剖宫产术中应用切口局部超前镇痛的效果及对产妇的影响。方法：本院剖宫产术的初产妇200例，随机分为研究组(100例)及对照组(100例)，研究组术中应用联合药物于腹膜、腹直肌腱膜与皮下组织行局部麻醉，对照组采用0.9%氯化钠溶液，观察两组镇痛效果、泌乳情况、并发症及阿片类药物使用情况。结果： 研究组在72 h后镇痛效果非常明显，与对照组比较差异有统计学意义(P<0.01)，研究组初次母乳哺乳时间及肛门排气时间明显早于对照组(P<0.01)，研究组术后应用的阿片药物少于对照组(P<0.01)。结论：采用局部联合镇痛方法，镇痛效果显著，有利于母乳喂养及产后恢复，且安全、方便，值得推广使用。
[关键词] 剖宫产；超前镇痛；局部；联合镇痛
[中图分类号] R71 [文献标识码]A[文章编号]1674-4721(2011)03(b)-033-03
Local combined analgesia during cesarean section for preemptive analgesia
LIU Zhichun, TAN Deqing
Department of Gynaecology and Obstetrics, Heshan Maternal and Child Health Hospital, Yiyang City, Hunan Province, Yiyang 413002, China
[Abstract] Objective: To determine the effects of a method of local combined analgesia and the influence in post-cesarean patients. Methods: 200 cases of cesarean section were randomly assigned into research group (100 cases) and control group (100 cases). The former were treated with combined analgesia into the wound, including spraying of the peritoneum, rectus aponeurosis edges and subcutaneously along the skin wound edges, and the latter with saline. The analgesia effects, the condition of breast feeding, gastrointestinal tract and need for opioids were observed. Results: The effects of cesarean in research group were significantly better than those in control group 72 hours after operations. The post-operative breast feeding and passage of gas by anus in research group were earlier than those in control group. The amount of pethidine used in the 72 hours was reduced in the research group. Conclusion: The local combined analgesia has a significant analgesia effect, and is benefit to breast feeding and postoperative recovery. Otherwise, it is safe, convenient and worthy application.
[Key words] Cesarean section; Preemptive analgesia; Local; Combined analgesia
剖宫产术已成为产科的一种常见手术，术后疼痛不仅影响产妇的术后康复，也影响产妇的哺乳及与新生儿的交流，本研究旨在探讨一种新的剖宫产围术期联合镇痛方法的效果及对产妇的影响。
1 资料与方法
1.1一般资料
2009年1月～2010年12月在本院选择剖宫产术的连续初产妇200例，随机数字法分为研究组(100例)及对照组(100例)，两组患者术前均身体健康，在孕周、年龄、体重等方面均差异无统计学差异，均无药物成瘾史、慢性疼痛史。所有患者均于术前签署实验知情同意书。两组手术均由同一组医师共同完成 ......
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