剖宫产术后硬膜外自控镇痛的临床护理研究

Clinical nursing Study of postopralve epidural patient - controlled analgesia in Cesarean Scar

目的：探讨割宫产术后硬膜外自控镇痛（PCEA）的护理观察要点。方法：观察40例PCEA（P）组和40例肌注（M）组病人的镇痛、镇静效应、副作用，观察PCEA对血压、心率及呼吸频率的影响。结果：①PCEA镇痛效果优于传统肌注组（P〈0．05）；②P组93％病人Ramsay氏分级维持在Ⅱ级。镇静效果较M组好（P〈0．05）；③副作用：P组恶心、呕吐的发生比M组低（P〈0．05），两组皮肤瘙痒，呼吸抑制的发生无差异；④PCEA对血压、心率、呼吸频率无明显影响。结论：PCEA镇痛、镇静效果好，较安全，护理中要注意观察副作用，防止并发症的发生。

Objectives To explore the nursing observation of the cesarean scar postoperative patient - eontrlled epidural analgesia（PCEA）. Methods ： We observed the effect and the side - effect of analgesia and in 40 cases of PCEA（P） group and in 40 cases of muscular injection （M） group as well as changes of blood pressure , heart rate and respiratory frequency in PCEA group. Result ①Analgesic effect was significatly better in PCEA group than in M group P 〈 0.05 ; ②Sedative effect was signficatly better in PCEA group than in M group. 93% patients in PCEA group maintained grade Ⅱ of Ramsay＇s classifcation ; ③Side - effect ： the incidence of nausea and vomiting in PCEA group was lower than that in M group （ P 〈0.05 ） ,while the incidences of pruritus and respiratory depression wets similar in two groups ; ④The blood pressure , heart rate and respiratory frequency were not changed in PCEA group. Conclusion The effects of analgesia , sedation were fine in PCEA. PCEA is secure. It is nessessary to observe the side - effect in nusing. To avoid syndrome.