剖宫产术后不同镇痛方法的效果比较

目的观察不同镇痛方法对剖宫产术后产妇的镇痛效果。方法将剖宫产术分娩的产妇100例患者随机分组，每组各50例。采用自控硬膜外镇痛（PCEA）微量注射泵为PCEA组；采用自控静脉镇痛（PCIA）微量注射泵为PCIA组。观察并记录患者术后的疼痛情况、头痛头晕、恶心呕吐、术后排气、拔除尿管后的第1次排尿时间以及意外脱管等。结果PCEA组、PCIA组患者的平均手术时间分别为（53．5±8．5）min、（54．7±8．2）min，两组间手术时间差异无统计学意义（t=1．524，P〉0．05）；PCEA组视觉模拟评分（1．49±0．43）分明显高于PCIA组（1．13±0．56）分（t=2．119，P〈0．05）；PCEA组患者术后头痛头晕、恶心呕吐、皮肤瘙痒发生率（30．0％、16．0％、6．0％）明显高于PCIA组（16．0％、8．0％、2．0％）（t=2．223，t=2．313，t=2．283，均P〉0．05）；PCEA组第1次排气时间、第1次排尿时间[（24．56±8．77）h、（6．51±1．57）h]明显高于PCIA组[（19．29±8．16）h、（4．06±1．76）h]（t=2．445，t=2．415，P〈0．05）。结论静脉自控微量注射镇痛泵镇痛安全有效，有利于术后患者充分配合治疗和早期活动，促进早期康复。

The effect of postoperative analgesia in patients with cesarean by different paregoric methods

Objective To observe the analgesic effect after cesarean section with different paregoric meth-ods. Methods 100 cesarean patients were randomly divided into A and B group. A group adopted patient controlled epidura analgesia(PCEA) micro-injection pump;B group using patient controlled intravenous analgesia(PCIA) mi-cro-injection pump,patients were observed and recorded for their pain, vomit disgustingly, exsufflation and the time of first urination or accidentally tube pull-out. Results The time of average surgery for A, B group were (53.5±8.5) min, (54.7±8.2) min, between the two groups was not significant (t=1.524, P>0.05) ; A group of visual Analog score (1.49±0.43) points were significantly higher than B group (1.13±0.56) points(t=2.119,P<0.05) ;the incidence of headache, dizziness, nausea and vomiting, skin itching(30.0%, 16.0% ,6.0%) in A group were signifi-candy higher than B group(16.0%,8.0% ,2.0%) (t=2.223, t=2.313, t=2.283, all P>0.05) ; the time of A first exhaust,voiding time[(24.56±8.77) h, (6.51±1.57) h] in A group were significantly higher than B group [(19.29±8.16)h,(4.06±1.76)h](t=2.445,t=2.415,P<0.05). Conclusion PCIA method was safe,effec-tive and allowed patients to have early activities after treatment and to promote early rehabilitation. It should be promo-ted for cesarean section.