硬膜外自控镇痛对剖宫产后患者感染及疼痛相关血清指标的影响观察

Effect of epidural analgesia on infection and pain related serum indexes in patients with cesarean section

目的研究硬膜外自控镇痛对剖宫产后患者感染及疼痛相关血清指标的影响,为临床提供依据。方法选取2015年1月—2016年1月平煤神马医疗集团总医院诊治的98例剖宫产产妇资料进行分析,将患者根据随机数字方法分为对照组和试验组,每组49例。对照组给予100mg盐酸哌替啶镇痛治疗,试验组给予150mg罗哌卡因混合0.5mg芬太尼、5mg氟哌利多混合100ml生理盐水中进行硬膜外自控镇痛,比较两组产妇产后感染及疼痛相关血清指标。结果试验组产妇第3天体温恢复及白细胞正常率,显著高于对照组(P<0.05);试验组第7d体温灰度及白细胞正常率,显著低于对照组(P<0.05);两组产妇术前血浆黏度、红细胞聚集指数、全血低切黏度以及全血还原低切黏度差异不具有统计学意义(P>0.05);试验组产妇术后血浆黏度、红细胞聚集指数、全血低切黏度以及全血还原低切黏度,显著低于对照组(P<0.05);两组产妇术前P物质、β-内啡肽及神经肽Y指标差异无统计学意义(P>0.05);试验组产妇术后P物质、β-内啡肽及神经肽Y指标,显著低于对照组(P<0.05)。结论与盐酸哌替啶镇痛相比,产妇剖宫产后采用硬膜外自控镇痛效果理想,能够降低术后感染率,能改善疼痛相关血清指标,值得推广应用。

Objective To study the effect of epidural analgesia on the infection and pain related serum indexes of patients after cesarean section,and to provide evidence for clinical treatment. Methods The data of 98 cases of cesarean section in Pingmei General Hospital from January 2015 to January 2016 in were analyzed. The patients were divided into the control group and the experimental group according to the random number method,49 cases in each group. The control group was treated with hydrochloric acid,and the experimental group was treated with epidural analgesia. The two groups of maternal postpartum infection and pain related serum indexes were compared between the two groups.Results The normal rate of test groups were third days of recovery of body temperature and white blood cells,significantly higher than the control group（ P〈0. 05）; The normal rate of test group at 7d temperature of gray and white blood cells were significantly lower than those the control group（ P〈0. 05）; The two groups of plasma viscosity,erythrocyte aggregation index,blood viscosity and blood reduced low viscosity difference were not statistically significant（ P〈0. 05）; The experimental group after maternal plasma viscosity,erythrocyte aggregation index,blood viscosity and blood reduced viscosity,significantly lower than those the control group（ P〈0. 05）; The two groups of substance P,there was no significant difference of beta endorphin and neuropeptide Y index（ P〈0. 05）; Substance P,beta test group after maternal endorphin and neuropeptide Y index was significantly lower than those the control group（ P〈0. 05）.Conclusion Compared with the analgesic effect of hydrochloric acid,maternal cesarean section with epidural self-control analgesia effect is ideal,can reduce postoperative infection rate,can improve the pain related serum indicators,it is worth promoting the application.