舒芬太尼硬膜外自控镇痛对重度子痫前期病人的影响

The effect of PCEA with sufentanil on patients with severe pre-eclampsia

目的探讨舒芬太尼硬膜外自控镇痛对重度子痫前期病人剖宫产术后的影响。方法选择以剖宫产终止妊娠的重度子痫前期病人64例,随机分为两组,观察组和对照组,观察组在剖宫产术后给舒芬太尼硬膜外自控镇痛,对照组术后给肌肉注射盐酸哌替啶镇痛,观察两组病人术后48小时镇痛效果、病人生命体征(血压、心率、血氧饱和度)变化和血液应激激素的水平及产后严重并发症和产后出血的发生情况。结果观察组术后48小时镇痛效果满意,血压控制理想、心率平稳、血氧饱和度升高,和对照组比较,差异有统计学意义(P<0.01);观察组术后48小时内血液应激激素含量明显低于对照组,差异有统计学意义(P<0.01);观察组术后48小时严重并发症发生率、出血量和对照组比较,明显低于对照组,差异有统计学意义(P<0.01);结论对重度子痫前期病人剖宫产术后采用舒芬太尼硬膜外自控镇痛效果确切,可以有效控制病情,减少重度子痫前期病人术后严重并发症和产后出血量。

Objective： To explore the effect of patient controlled epidural analgesia（PCEA） with sufentanil on patients with severe pre-eclampsia underwent caesarian section.Methods： Sixty-four patients with severe pre-eclampsia underwent caesarian section were randomly divided into two groups,the observe group and the control group.All patients in the observe group were administrated PCEA with Sufentanil,and analgesia to all the patients in the control group were used with intramuscular injection of pethidine hydrochloride.The analgesic effect at 48 h were observed and the BP,HR,SaO2,stress hormone levels were recorded in both of the two groups,together with the severe complications and postpartum hemorrhage cases were observed after the operation.Results： The analgesic effect was significantly different between the two groups（P0.01）.The BP,HR,SaO2 of the observe group were more stable than that of the control group.The stress hormone levels,severe complications and postpartum hemorrhage cases in the observe group were significantly lower than those in the control group（P0.01）.Conclusion： PCEA with sufentanil on patients with severe pre-eclampsia underwent caesarian section can have exact analgesic effect and can effectively control the disease,and can also reduce postoperative severe complications and postpartum hemorrhage.