舒芬太尼PCEA对重度妊高征剖宫产病人术后SIRS的影响

Effect of autocontrol analgesia pump with Sufentanyl on systemic inflammatory response syndrome after cesarean section for severe pregnancy induced hypertension

目的:观察舒芬太尼硬膜外病人自控镇痛(PCEA)对重度妊娠期高血压疾病(HDCP)剖宫产病人术后全身炎症反应综合征(SIRS)的影响。方法:确诊HDCP病人120例,均硬膜外神经阻滞麻醉下行横切口剖宫产术,术后采取随机数字双盲对比法均分为舒芬太尼PCEA组(S组)、芬太尼PCEA组(F组)和对照组(D组),以术前1h相关数据为基础值(T0),对比观察术后4(T1)、24(T2)、48(T3)和72h(T4)PH疼痛程度评分与SIRS评分,并以术后7天病例资料对比相关并发症。结果:术后各时点PH疼痛程度评分S组低于F组,差异无显著意义(P>0.05);S、F组均极显著低于D组(P<0.01)。SIRS评分术后各时点同组较术前均呈逐渐下降,T2时即与术前有极显著意义(P<0.01)。同时点术后SIRS评分组间对比S组下降最明显,较F组差异有显著意义(P<0.05);较D组差异均有极显著意义(P<0.01)。S组PCEA相关并发症低于F组,差异无显著意义(P>0.05);而S、F组哺乳延迟、高糖血症与睡眠障碍等并发症较D组比较差异有极显著意义(P<0.01)。结论:舒芬太尼PCEA可进一步降低HDCP剖宫产病人应激反应,减缓SIRS的病情,有助于进一步减少HDCP相关并发症的发生。

Objective： To observe effect of autocontrol analgesia pump with sufentanyl on systemic inflammatory response syndrome after cesarean section for severe pregnancy induced hypertension. Methods： 120 cases in severe pregnancy induced hypertension were divided into three groups such as sufentanyl group, fentanyl group and control group at random, who accepted cesarean section. Degree of pain and systemic inflammatory response syndrome was recorded at4h （T1）, 24h （T2）, 48h （T3）, 72h （T4） after operation and lh （TO） before operation respectively. Those data were analyzed, so did the related symptom in 7 d after operation. Results： Degree of pain were no significant differences （ p 〉 0.05 ） between sufentanyl group and fentanyl group. However their scale compared with control group were significant differences （ p 〈 0. 01 ） . Degree of systemic inflammatory response syndrome were significant differences （ p 〈 0. 05 ） between sufentanyl group and fentanyl group, their scale compared with control group were also significant differences （p 〈 0. 01 ） . Although related symptom in 7 d after operation were no significant differences （ p 〉 0. 05 ） among three groups, those symptoms such as delayed lactation, higher glycemia and sleep disorder were significant differences （p 〈0. 01 ） between control group and other groups. Conclusion： Autecontrol analgesia pump with sufentanyl can be helpful to perioperative management and reduce stress reaction after cesarean section for severe pregnancy induced hypertension. Moreover, related symptom is also lower.