發(fā)布時(shí)間：2019-01-24 13:49

【摘要】：目的:比較嗎啡與納布啡對(duì)剖宮產(chǎn)產(chǎn)婦術(shù)后相關(guān)指標(biāo)的影響。方法:120例行剖宮產(chǎn)術(shù)的產(chǎn)婦隨機(jī)分為觀察組(60例)和對(duì)照組(60例)。術(shù)后,觀察組產(chǎn)婦采用鹽酸納布啡注射液20 mg+0.75%鹽酸羅哌卡因注射液20 mL,硬膜外自控鎮(zhèn)痛;對(duì)照組產(chǎn)婦采用鹽酸嗎啡注射液8 mg+0.75%鹽酸羅哌卡因注射液20 mL,硬膜外自控鎮(zhèn)痛。觀察并比較兩組產(chǎn)婦鎮(zhèn)痛開(kāi)始時(shí)(T_0)、鎮(zhèn)痛后6 h(T_1)、12 h(T_2)、24 h(T_3)、48 h(T_4)時(shí)的視覺(jué)模擬疼痛(VAS)評(píng)分、收縮壓、舒張壓、呼吸速率(RR)、血氧飽和度(SpO_2),T_0、T_3、T_4時(shí)的白細(xì)胞介素6(IL-6)、IL-8、C反應(yīng)蛋白(CRP)、泌乳素(PRL)水平,鎮(zhèn)痛滿意率及不良反應(yīng)發(fā)生情況。結(jié)果:兩組產(chǎn)婦鎮(zhèn)痛滿意率比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(96.67%vs.98.33%,P0.05)。兩組產(chǎn)婦T_0、T_1、T_4時(shí)VAS評(píng)分比較,差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);T_2-3時(shí),兩組產(chǎn)婦VAS評(píng)分均顯著高于同組T_0、T_1及T_4時(shí),差異均有統(tǒng)計(jì)學(xué)意義(P0.05);但兩組間比較,差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。兩組產(chǎn)婦T_0-2時(shí)的收縮壓及不同時(shí)間點(diǎn)的舒張壓、RR、SpO_2比較,差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);兩組產(chǎn)婦T_3-4時(shí)收縮壓均顯著高于同組T_0時(shí),差異均有統(tǒng)計(jì)學(xué)意義(P0.05);但兩組間比較差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。T_0時(shí),兩組產(chǎn)婦IL-6、IL-8、CRP、PRL水平比較,差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。T_3時(shí),兩組產(chǎn)婦IL-6、IL-8、CRP水平均顯著高于同組T_0時(shí),但觀察組顯著低于對(duì)照組;T_4時(shí),對(duì)照組產(chǎn)婦IL-6、IL-8、CRP水平均顯著高于同組T_0時(shí),差異均有統(tǒng)計(jì)學(xué)意義(P0.05),而觀察組產(chǎn)婦T_0與T_4時(shí)比較,差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。兩組產(chǎn)婦T_3-4時(shí)PRL水平均顯著高于同組T_0時(shí),隨時(shí)間延長(zhǎng)逐漸升高,且觀察組顯著高于對(duì)照組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。觀察組產(chǎn)婦不良反應(yīng)發(fā)生率顯著低于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:納布啡用于剖宮產(chǎn)產(chǎn)婦術(shù)后的鎮(zhèn)痛效果、心血管影響與嗎啡相當(dāng),但在降低炎性水平、促進(jìn)泌乳、安全性方面優(yōu)于嗎啡。
[Abstract]:Objective: to compare the effect of morphine and naporphine on postoperative indexes of cesarean section. Methods: 120 cases of cesarean section were randomly divided into observation group (60 cases) and control group (60 cases). After operation, the patients in the observation group were given epidural analgesia with naporphine hydrochloride injection 0.75% ropivacaine hydrochloride injection for 20 mL,. In the control group, morphine hydrochloride injection 8 mg 0.75% ropivacaine hydrochloride injection 20 mL, patient-controlled epidural analgesia was used. The (VAS) scores of visual analogue pain, systolic pressure and diastolic pressure were observed and compared at the beginning of analgesia (T _ 0), 6 h (T _ S _ 1), 12 h (T _ 2), 24 h (T _ 3), 48 h (T _ 4) after analgesia. Respiratory rate (RR), blood oxygen saturation (SpO_2), T _ 0 / T _ (3) / T _ (3) T _ (4) IL-6, IL-8,C reactive protein (CRP), prolactin (PRL), Satisfaction rate of analgesia and occurrence of adverse reactions. Results: there was no significant difference in the rate of analgesia between the two groups (96.67vs.98.33). There was no significant difference in VAS score between the two groups at the time of T _ 0 / T _ 1 / T _ 4 (P0.05). The VAS scores of the two groups were significantly higher than those of the same group at the time of T _ 2-3 (P0.05), but there was no significant difference between the two groups (P0.05). There was no significant difference in systolic blood pressure and diastolic blood pressure (RR,SpO_2) between the two groups at T0-2 (P0.05). Systolic blood pressure (SBP) of the two groups at T3-4 was significantly higher than that of the same group (P0.05). However, there was no significant difference between the two groups (P0.05). There was no significant difference in the level of IL-6,IL-8,CRP,PRL between the two groups (P0.05). At T3, there was no significant difference in IL-6, between the two groups. The level of IL-8,CRP in the observation group was significantly higher than that in the control group at 0, but in the observation group was significantly lower than that in the control group. The levels of IL-6,IL-8,CRP in the control group were significantly higher than those in the same group at T _ 4 (P0.05), while those in the observation group were significantly higher than those in the control group at T _ 4 and T _ 4, respectively. The difference was not statistically significant (P0.05). The levels of PRL in the two groups were significantly higher than those in the same group at T3-4 and gradually increased with the prolongation of time, and the levels of PRL in the observation group were significantly higher than those in the control group (P0.05). The incidence of adverse reactions in the observation group was significantly lower than that in the control group (P0.05). Conclusion: the analgesic effect of naporphine in cesarean section is similar to that of morphine, but it is superior to morphine in reducing inflammatory level and promoting lactation.
【作者單位】： 白銀市第一人民醫(yī)院疼痛麻醉科;
【分類號(hào)】：R614

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 周斌;夏中元;;氫嗎啡酮聯(lián)合羅哌卡因用于婦科術(shù)后自控硬膜外鎮(zhèn)痛[J];中國(guó)新藥與臨床雜志;2015年08期

2 劉禮勝;錢偉民;李榮;代文杰;王福涌;;地佐辛復(fù)合低濃度羅哌卡因硬膜外自控分娩鎮(zhèn)痛在無(wú)痛分娩中的應(yīng)用[J];中國(guó)藥房;2014年36期

3 李桂銀;李桂清;;左旋布比卡因與羅哌卡因用于剖宮產(chǎn)術(shù)后硬膜外自控鎮(zhèn)痛效果比較[J];中國(guó)藥業(yè);2013年21期

4 崔旭;唐晨;趙曉艷;;硬膜外嗎啡復(fù)合靜脈鎮(zhèn)痛用于剖宮產(chǎn)術(shù)后鎮(zhèn)痛的臨床觀察[J];中國(guó)醫(yī)刊;2013年11期

5 項(xiàng)雪琴;;嗎啡復(fù)合地佐辛用于剖宮產(chǎn)術(shù)后鎮(zhèn)痛100例[J];中國(guó)藥業(yè);2013年11期

6 吳青;;硬膜外自控鎮(zhèn)痛對(duì)剖宮產(chǎn)產(chǎn)婦術(shù)后機(jī)體康復(fù)及泌乳情況的影響觀察[J];中國(guó)婦幼保健;2013年15期

7 伊首璞;陳忠明;張繼虹;張寬仁;;阿片類受體亞型間相互作用研究進(jìn)展[J];中國(guó)藥理學(xué)通報(bào);2012年11期

8 蔣紅喜;;硬膜外自控鎮(zhèn)痛用于剖宮產(chǎn)術(shù)后的療效觀察[J];臨床和實(shí)驗(yàn)醫(yī)學(xué)雜志;2009年07期

9 康凱;徐銘軍;;剖宮產(chǎn)術(shù)后鎮(zhèn)痛的策略進(jìn)展[J];中國(guó)誤診學(xué)雜志;2008年10期

10 程慕婧;;剖宮產(chǎn)術(shù)后硬膜外自控鎮(zhèn)痛對(duì)母乳喂養(yǎng)的影響[J];實(shí)用臨床醫(yī)學(xué);2007年02期

相關(guān)碩士學(xué)位論文 前1條

1 黃強(qiáng);布托啡諾預(yù)防剖宮產(chǎn)術(shù)后硬膜外嗎啡鎮(zhèn)痛副作用的研究[D];暨南大學(xué);2010年

【共引文獻(xiàn)】

相關(guān)期刊論文 前10條

1 丁亞平;魏萬(wàn)鵬;和建杰;;嗎啡與納布啡對(duì)剖宮產(chǎn)產(chǎn)婦術(shù)后相關(guān)指標(biāo)的影響比較[J];中國(guó)藥房;2017年21期

2 李建賓;惠建偉;何婉雯;郭瑞;陳友利;黃強(qiáng);;氫嗎啡酮對(duì)剖宮產(chǎn)術(shù)后鎮(zhèn)痛作用及對(duì)免疫的影響[J];檢驗(yàn)醫(yī)學(xué)與臨床;2017年14期

3 齊正倫;吳征;;羅哌卡因與左旋布比卡因在剖宮產(chǎn)手術(shù)腰硬聯(lián)合麻醉中應(yīng)用比較[J];淮海醫(yī)藥;2017年04期

4 朱琳;羅穗豫;;硬膜外自控鎮(zhèn)痛對(duì)剖宮產(chǎn)后患者感染及疼痛相關(guān)血清指標(biāo)的影響觀察[J];醫(yī)藥論壇雜志;2017年06期

5 朱劍峰;;硬膜外阻滯誘導(dǎo)后靜脈注射地佐辛對(duì)剖宮產(chǎn)術(shù)后疼痛的影響[J];臨床合理用藥雜志;2017年16期

6 陳素蘭;;皮下注射鹽酸氫嗎啡酮聯(lián)合經(jīng)靜脈自控鎮(zhèn)痛用于術(shù)后鎮(zhèn)痛的安全性及效果分析[J];海軍醫(yī)學(xué)雜志;2017年03期

7 黃唯;;羅哌卡因聯(lián)合舒芬太尼硬膜外麻醉對(duì)可行走無(wú)痛分娩鎮(zhèn)痛效果研究[J];中外醫(yī)學(xué)研究;2017年13期

8 徐文平;劉林;肖飛;張小敏;錢晶;;羅哌卡因聯(lián)合舒芬太尼硬膜外麻醉對(duì)可行走無(wú)痛分娩陣鎮(zhèn)痛的效果研究[J];中國(guó)生化藥物雜志;2017年04期

9 林金兵;麥星霞;杜順顏;胡旭東;池鴻熙;吳昊;;帕瑞昔布鈉對(duì)地佐辛在剖宮產(chǎn)患者術(shù)后靜脈鎮(zhèn)痛效應(yīng)的影響[J];廣東醫(yī)學(xué);2017年07期

10 雷波;赫金鑫;賀淑君;王雷;郭敏;楊云龍;左娟;;鹽酸氫嗎啡酮聯(lián)合靜脈自控鎮(zhèn)痛在剖宮產(chǎn)術(shù)后鎮(zhèn)痛的臨床研究[J];山西醫(yī)藥雜志;2017年06期

【二級(jí)參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 陳蘭鳳;金豪杰;高寶斌;盧園園;李軍;;不同濃度羅哌卡因復(fù)合布托啡諾行硬膜外分娩鎮(zhèn)痛的量效觀察[J];中國(guó)臨床藥理學(xué)與治療學(xué);2013年10期

2 鄭麗娟;胡祖榮;賈杰;劉晶;黎昆偉;黃希照;;硬膜外分娩鎮(zhèn)痛對(duì)產(chǎn)痛、產(chǎn)程及分娩結(jié)局的影響[J];吉林醫(yī)學(xué);2013年05期

3 譚成平;;地佐辛用于硬膜外鎮(zhèn)痛的有效性和舒適性分析[J];中國(guó)當(dāng)代醫(yī)藥;2012年25期

4 張建華;孔蕊;崔利娜;謝文燕;;羅哌卡因聯(lián)合芬太尼用于產(chǎn)婦自控硬膜外分娩鎮(zhèn)痛的療效觀察[J];中國(guó)藥房;2012年32期

5 楊亞青;馬薇;李紅兵;;羅哌卡因與布比卡因用于剖宮產(chǎn)術(shù)后鎮(zhèn)痛的臨床對(duì)比分析[J];中國(guó)醫(yī)療前沿;2012年14期

6 黃詠;賀海林;王兆華;;探討提高剖宮產(chǎn)術(shù)后硬膜外鎮(zhèn)痛效果及減少不良反應(yīng)的方法[J];吉林醫(yī)學(xué);2012年01期

7 甘果;李誠(chéng);袁力勇;黃建平;方春峰;;瑞芬太尼病人靜脈自控鎮(zhèn)痛用于分娩鎮(zhèn)痛[J];醫(yī)學(xué)研究雜志;2011年09期

8 溫泉;顏玲娣;李玉蕾;宮澤輝;;阿片κ-受體和ORL1受體二聚化的初步研究[J];藥學(xué)學(xué)報(bào);2011年09期

9 蔡雪娟;;連續(xù)硬膜外自控鎮(zhèn)痛對(duì)剖宮產(chǎn)婦生存質(zhì)量及血清泌乳素、炎性因子影響觀察[J];中國(guó)婦幼保健;2011年25期

10 劉梅;管朝勇;;地佐辛復(fù)合舒芬太尼在剖宮產(chǎn)術(shù)后鎮(zhèn)痛中的應(yīng)用[J];中國(guó)誤診學(xué)雜志;2011年24期

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