硬膜外自控镇痛对剖宫产术后并发症及泌乳的影响

目的　观察硬膜外自控镇痛 (PCEA)对剖宫产术后并发症及泌乳的影响。方法　选择硬膜外麻醉下行剖宫产的初产妇 5 0 0例 ,其中 2 34例自愿用PCEA镇痛为研究组 ,另 2 66例未采用PCEA镇痛作为对照组。分别观察两组镇痛效果 ,肛门排气时间 ,泌乳情况及其他不良反应。结果　研究组镇痛效果明显优于对照组 (P <0 0 5 ) ,肛门排气早于对照组 (P <0 0 1) ,乳汁分泌量多于对照组 (P<0 0 5 ) ,研究组睡眠好 ,但有皮肤瘙痒、恶心呕吐等不良反应。结论　硬膜外自控镇痛法应用剖宫产术后镇痛持续时间长 ,效果确切安全 ,有利胃肠功能恢复 ,不影响子宫收缩 ,不影响膀胱功能 ,能减少产后并发症 ,促进母乳喂养。

Influence of the Use of Patient Self Controlled Epidural Analgesia on the Complications of Cesarean Section and Lactation

Objective To observe the influence of patient self controlled epidural analgesia (PCEA) on the complications of cesarean section and lactation. Method 500 primigravidas accepting epidural anesthesia were involved in this study. 234 cases taking PCEA voluntarily were chosen as test group and the other 266 cases were chosen as control group. The analgesic effect, the time of anal exsufflation, lactation and other side effects were observed. Results The analgesic effect, the time of anal exsufflation and the content of milk secretion in the test group were all superior than that of the control group (P<0,05). The test group had no dyssomnia, puerperal bleeding, respiratory depression and urinary retention. Conclusion The application of PCEA in cesarean section prolongs the analgesic time, promotes the recovery of the gastrointestinal function, has no effect on uterine contraction and bladder function, reduces the puerperal complications and benefits breast feeding. It is worth being applied extensively in the clinic.