舒芬太尼复合罗哌卡因椎管内分娩镇痛对减少产后性功能障碍作用

Sufentanil and ropivacaine intrathecal labor analgesia in reducing postpartum sexual dysfunction

目的:探讨舒芬太尼复合罗哌卡因用于连续硬膜外阻滞(CEA)与腰硬联合阻滞(CSEA)分娩镇痛对减少产后性功能障碍的作用。方法:选取本院正常足月妊娠、头胎、要求阴道分娩的产妇86例,随机分为A组、B组、C组,A组为CEA组,B组为CSEA组,C组为未进行无痛分娩的产妇,分别记录并分析所有产妇产后3个月、6个月、9个月的性功能评分(FSFI)。结果:产后3个月A组、B组、C组FSFI总分分别为(24.82±3.21)分、(26.95±2.87)分、(28.65±3.92)分,产后6个月A组、B组、C组FSFI总分分别为(27.85±3.80)分、(31.19±3.69)分、(31.70±4.12)分,三组产妇的性交疼痛、性高潮、性满意度及总分具有统计学差异(P<0.05)。产后9个月A组、B组、C组FSFI总分分别为(36.15±2.97)分、(36.19±2.96)分、(36.37±3.35)分,总分及各项评分差异不具有统计学意义(P>0.05)。结论:三组方式相比,顺产对产妇产后性功能水平恢复影响最小,其次为腰硬联合阻滞(CSEA)麻醉的无痛分娩,相对于连续硬膜外阻滞(CEA)能显著减少产后性功能障碍。

Objectives： To investigate the effect of sufentanil and ropivacaine for continuous epidural anesthesia（ CEA） and combined spinal epidural（ CSEA） on reducing postpartum sexual dysfunction. Methods： 86 puerperae that required painless vaginal delivery with full- term pregnancy and firstborn were selected and randomly divided into group A ／ B ／ C. Group A group was CEA group,group B was CSEA group and group C did not perform painless delivery. The sexual function and postpartum depression level and time to return sexual life and the frequency of sexual activity was recorded 3,6 and 9 months respectively after treatment. Results： The postpartum 3months was（ 24. 82 ± 3. 21）,（ 26. 95 ± 2. 87） and（ 28. 65 ± 3. 92） in group A,B and C respectively,while those at postpartum 6 months were（ 27. 85 ± 3. 80）,（ 31. 19 ± 3. 69） and（ 31. 70 ± 4. 12） respectively,without statistically significant difference in total score（ P〈0. 05）. Those at 9 months postpartum in group A,B and C were（ 36. 15 ± 2. 97）,（ 36. 19 ± 2. 96） and（ 36. 37 ± 3. 35） respectively,without statistically significant difference in total score（ P〉0. 05）. Conclusion： Among the 3 treatment methods,natural labor has the minimal impact on postpartum sexual function recovery,followed by CSEA anesthesia painless childbirth,which can also significantly reduce postpartum sexual dysfunction compared CEA.