剖宫产术后患者自控镇痛不同途径给药的临床效果分析

Analysis on the clinical effect of patient-controlled analgesia with different route of administration in patients after cesarean section

目的探讨剖宫产术后患者自控镇痛(PCA)不同途径给药的临床效果。方法选取2011年4～12月本院产科VIP区进行横切口子宫下段剖宫产术的150例足月妊娠产妇为研究对象,将其按照不同镇痛方式分为患者静脉自控镇痛(PCIA)组与硬膜外自控镇痛(PCEA)组每组各75例,比较两组镇痛效果及副反应,24h阴道流血情况、排气时间、下床活动时间以及母乳喂养情况。结果两组均能达到很好的镇痛效果,但PCIA组皮肤瘙痒、排尿不畅、恶心呕吐、头痛头昏、下肢麻木、尿潴留发生率均低于PCEA组。排气和下床活动时间,开奶时间和母乳喂养次数都明显优于PCEA组。PCIA组的产妇排尿更为通畅,睡眠质量也明显优于PCEA组,差异有统计学意义(P<0.05)。结论患者静脉自控镇痛(PCIA)比硬膜外自控镇痛(PCEA)镇痛结果更好,且副反应更少,可有效促进各项身体功能的恢复。

Objective To investigate the clinical effect of patient-controlled analgesia with different route of administration in patients after cesarean section.Methods One hundred and fifty cases of term pregnancy women who were treated with transverse incision in the lower uterine segment cesarean section in our hospital from April to December 2011 were select ed as research object,and they were divided into patient controlled intravenous analgesia（PCIA） group and patient-con trolled epidural analgesia（PCEA） group with 75 cases in each group,then the analgesic efficacy and side effects,vaginal bleeding situation in 24 hours,exhaust time,getting out of bed time and breast feeding situation of two groups were com pared.Results The analgesic effects of two groups were all better,while the rate of maternal skin itching,urination,nausea,vomiting,headache,dizziness,numbness and urinary retention of PCIA group were lower than those of PCEA group,the ex haust time,getting out of bed time,opening milk and breast-feeding times were significantly better than those of the PCEA group,maternal urinate of PCIA group was more smooth,sleep quality was obvious better than that of PCEA group,there were significant differences（P 〈0.05）.Conclusion The analgesic effects of intravenous analgesia（PCIA） for the patients is better than that of patient-controlled epidural analgesia（PCEA）,and the side effects is less,so it can effectively promote the recovery of various body function.