不同镇痛方法对产妇血清泌乳素的影响

Comparison the effect of different analgesic techniques on the serum prolactinl PRL~ of puerpera after caesarean section

目的评价不同镇痛方法对剖宫产术后产妇血清中泌乳素（PRL）的影响。方法根据镇痛方法不同，将300例产妇随机分为三组：第1组患者为术后根据临床需要，临时给予哌替啶50mg肌内注射（I组，n=100）；第Ⅱ组患者为罗哌卡因复合芬太尼持续硬膜外镇痛组（Ⅱ组，n=100）；第Ⅲ组患者为芬太尼持续静脉镇痛组（HI组，n=100）；分别于剖宫产手术结束时、术后2h、24h及48h抽取产妇静脉血，测定血清PRL，并观察镇痛效果及哺乳情况。结果在剖宫产手术结束时三组产妇血清PRL无明显差异，术后2h、24h及48hII组和Ⅲ组产妇血清PRL值显著高于I组（P〈0．05）。与Ⅲ组比较，Ⅱ组更为明显（P〈0．05）。结论剖宫术后持续硬膜外镇痛及静脉镇痛均增加PRL的分泌。尤其硬膜外局麻药复合阿片受体激动药镇痛模式更有效，有利于早期哺乳。

Objective To compare the effect of different analgesic techniques on the levels of serum prolacti n（PRL） of puerperas after caesarean section. Methods Three hundreds puerperas after caesarean section were randomly di- vided into three groups. GroupIreceived 50 mg pethidine when needed,GroupIIreceived ropivacaine ＋ fentanyl for PCEA,groupIIIreceived fentanyl for PCIA. The levels of serum PRL were observed at three time points： the end of surgery, at 2,24,48 h after the end of surgery. Results There were no significant differences in terms of serum PRL in three groups at the end of surgery . The serum PRL were significantly higher at 2, 24 and 48 h in groupIIand gtoupIllthan those in groupI（ P〈0.05 I. Compared with group m, the serum PRL was significantly higher at 24 h in groupll（P〈0. 05） . Conclusion PCEA and PCIA can increase the levels of serum PRL and this is effective with an increase of prolactin secretion. PCEA is more efficient than PCIA.