甲硫酸新斯的明注射液在剖宫产术后胃肠功能恢复的应用研究

Application of neostigmine methylsulfate injection in gastrointestinal function recovery after cesarean section

目的研究甲硫酸新斯的明注射液在剖宫产术后胃肠功能恢复的应用效果。方法选择2019年2月至2020年8月在保定市第一医院进行剖宫产的产妇360例,随机分为对照组、实验1组及实验2组,每组120例。对照组剖宫产术后进行常规处理,实验1组术后即刻肌肉注射1mg甲硫酸新斯的明,实验2组即刻肛塞1mg卡前列甲酯栓。对比三组产妇术后肠鸣音恢复时间、首次排气时间和排便时间,术后腹胀、乳汁分泌情况及肠梗阻发生情况。结果实验1组术后肠鸣音恢复时间、首次排气时间和排便时间少于对照组和实验2组(实验1组vs.对照组:t值分别为9.313、10.995、10.357;实验1组vs.实验2组:t值分别为4.925、6.207、3.599,均P<0.05),实验2组术后肠鸣音恢复时间、首次排气时间和排便时间少于对照组(t值分别为4.448、4.651、6.758,均P<0.05)。实验1组术后腹胀发生率低于对照组和实验2组(χ^(2)值分别为31.493、12.227,均P<0.05),实验2组术后腹胀发生率低于对照组(χ^(2)=16.345,P<0.05)。实验1组24h初泌乳率高于对照组和实验2组(χ^(2)值分别为36.983、8.531,均P<0.05),实验2组24h初泌乳率高于对照组(χ^(2)=11.309,P<0.05)。实验1组和实验2组无肠梗阻发生,对照组有2例肠梗阻发生,组间比较差异无统计学意义(P>0.05)。结论甲硫酸新斯的明注射液能够促进剖宫产术后胃肠功能恢复,缩短剖宫产术后肛门排气时间,降低腹胀发生率,并可促进早泌乳。

Objective To study the effect of neostigmine methylsulfate injection in the recovery of gastrointestinal function after cesarean section.Methods 360 parturients who underwent cesarean section in Baoding First Hospital from February 2019 to August 2020 were randomly divided into control group,experimental group 1 and experimental group 2,with 120 cases in each group.The control group received routine treatment after cesarean section,while the experimental group 1 received intramuscular injection of 1 mg neostigmine methylsulfate immediately after operation,and the experimental group 2 received anal tampon of 1 mg carboprost methylate suppositories immediately.The recovery time of bowel sounds,first exhaust time and defecation time,postoperative abdominal distension,milk secretion,and intestinal obstruction of the three groups were compared.Results The recovery time of bowel sounds,first exhaust time,and defecation time in experimental group 1 were less than those in the control group and experimental group 2(compared with the control group,t=9.313,10.995 and 10.357,respectively;compared with experimental group 2,t=4.925,6.207 and 3.599,respectively,all P<0.05),while the recovery time of bowel sounds,first exhaust time and defecation time in experimental group 2 were less than those in the control group(compared with the control group,t=4.448,4.651 and 6.758,respectively,all P<0.05).The postoperative abdominal distension rate in experimental group 1 were lower than those in the control group and experimental group 2(χ^(2)=31.493 and 12.227,respectively,both P<0.05),while postoperative abdominal distension rate in experimental group 2 were lower than those in the control group(χ^(2)=16.345,P<0.05).The 24-hour lactation rate of experimental group 1 was higher than that of the control group and experimental group 2(χ^(2)=36.983 and 8.531,respectively,both P<0.05),and 24-hour lactation rate of experimental group 2 was higher than that of the control group(χ^(2)=11.309,P<0.05).There was no intestinal obstruction in experimental group 1 and experimental group 2,and there were 2 intestinal obstructions in the control group.There was no statistically significant difference among the groups(P>0.05).Conclusion Neostigmine methsulfate injection can promote the recovery of gastrointestinal function after cesarean section,shorten the time of anal exhaust after cesarean section,reduce the incidence of abdominal distention,and promote early lactation.