剖宫产术后硬膜外镇痛对母乳喂养新生儿精神行为能力的影响

Effect of epidural analgesia on breast-feeding and newborn energetic adaptive capacity in parturients cesarean section

目的观察剖宫产术后应用吗啡类硬膜外镇痛对母乳喂养及新生儿精神行为能力的影响。方法选择ASAI-II级足月妊娠剖宫产孕妇120例,随机分为镇痛I组、镇痛II组和对照组。结果两镇痛组镇痛效果满意,对呼吸、循环功能无明显影响。两镇痛组产后24h开奶例数、产后24h哺乳3～8次例数明显高于对照组(P<0.01)。镇痛组肠排气时间早,无并发症。三组新生儿在各时点的神经和适应能力评分值均大于35分,三组间比较差异无显著性(P>0.05)。结论剖宫产术后应用吗啡类硬膜外患者自控镇痛效果可靠,并能降低术后产妇的应激反应,消除疼痛导致的焦虑、紧张等情绪反应,促进早开奶,利于母乳喂养,对母乳喂养的新生儿精神行为无明显不良影响,可安全应用于临床。

Objective To evaluate epiduaral analgesia（ PCEA） with morphine on breast-feeding and newborn energetic adaptive capacity in parturients cesarean section. Methods Chooses ASA the I-II level fullterm pregnancy woman 120 examples after cesarean section,divides into stochastically eases the pain I group, eases the pain II level of and the control group. Results Two analgesia group analgesic effect is satisfied,to breathes,the loop function affects not obviously. Two analgesia group post-natal 24 h opens the milk example number,post-natal 24 h nurses 3-8 time example number to be higher than the control group obviously（ P 0. 01） . The analgesia group intestines exhaust time morning,does not have the complication. Three group of newborns are bigger than in during various points in time nerve and the adaptiveness grading value for 35 minutes,three group of comparison differences do not have the significance（ P 0. 05 ） . Conclusion Cesarean section and postoperative patient controlled epidural morphine analgesia can be reliable,and can reduce the parturients stress to respond,eliminates the ache to cause anxious,and so on the mood to respond,the promotion opens the milk early,favors breast-feeding. The PCEA with morphine mentioned above can be safe for neonatesin parturients after cesarean section.