剖宫产术后硬膜外自控镇痛对泌乳的影响

The Influence of PCEA on Lactogenesis after Cesarean-Section

目的:探讨剖宫产术后硬膜外自控镇痛(PCEA)对产妇母乳喂养,乳汁分泌的影响。方法:240例产妇随机分成2组,一组剖宫产术后给予硬膜外自控镇痛(PCEA组),一组剖宫产术后疼痛时肌注派替啶50mg(对照组),二组均实行母婴同室和纯母乳喂养。监测剖宫产术后镇痛效果,肛门排气,泌乳活动情况以及术后血浆催乳激素(PRL)浓度变化。结果:PCEA组与对照组比较:镇痛效果显著(P<0.01),肛门排气无显著差异(P>0.05),术后初乳时间明显提前(P<0.05),24h母乳喂养次数显著增多(P<0.01),术后血浆PRL浓度显著升高。结论:剖宫术后使用PCEA效果好,应大力提倡使用PCEA。

Objective：To discuss the influence of patient-controlled epidural analgesia （PCEA） after cesarean section on breast feeding and lactogenesis. Methods： 240 puerperae were divided randomly into two groups. One group received patient - controlled epidurul analgesia（PCEA） after cesarean section （PCEA group）. Another group was given Pethidine 50mg by intramuscular injection （control group）. The rooming-in and complete breast feeding were practised in the two groups. The effcacy of analgesia, flatus passage, postoperative colostrous time, and serum prolactin（PRL） concentration were observed in the two groups.Results： There was significant difference（ P 〈 0.01）in the efficacy of analgesia, and no significant difference in flatus passage（ P 〉 0.05）. In the PCEA group the advances of postoperative colostrous time （ P 〈 0.05）and the frequency of breast feeding within 24 hours （ P 〈 0.01） were significant, and the postoperative serum PRL concentration significantly enhanced. Conclusion： The effcacy of patient-controlled epidural analgesia（PCEA） after cesarean section is satisfactory, so PCEA should be advocated.