硬膜外阻滞分娩镇痛对母乳喂养的影响

目的 研究硬膜外麻醉阻滞分娩镇痛对母乳喂养的影响,为临床促进母乳喂养探讨新的途径。方法 随机选择2001~2003年7月住院阴道分娩的健康产妇170例,采用持续硬膜外阻滞分娩镇痛产妇96例为观察组,未采用分娩镇痛及产后镇痛产妇74例为对照组。观察两组产妇的阵痛强度、产后精神状态、泌乳始动时间、泌乳量及24h内喂哺次数,分娩前及分娩48h后泌乳刺激素(PRL)水平,所得资料进行统计学处理。结果 观察组阵痛强度评分明显低于对照组,产后产妇精神状态明显优于对照组,差异有显著性(P<0.01);观察组产后泌乳始动时间短于对照组,72h内泌乳量多于对照组,差异有显著性(P<0.05);观察组产后48hPRL水平高于对照组,差异有显著性(P<0.05)。结论 持续硬膜外阻滞分娩镇痛及产后镇痛其镇痛效果确切、安全、副作用小,可明显缓解产妇的疼痛感,改善产妇的精神状态,促进母乳喂养。明显的镇痛效果降低体内儿茶酚胺水平,促进PRL分泌,利于母乳喂养。

Impact of epidural anesthesia during delivery on breast feeding

Objective To explore the influence of epidural anesthesia during delivery on breast feeding. Method A total of 170 healthy women hospitalized for vaginal delivery without obstetric complications during the year 2001 to July 2003 were analyzed, who were divided into observation group (n=96) with continuous epidural anesthesia and control group (n=74) without continuous epidural anesthesia or postpartum analgesia. The data of analgesic efficacy, postpartum mental state, starting time of lactation, milk quantity and the feeding times in 24 h and prolactin level before and 48 h after delivery were analyzed statistically. Results The women in the observation group reported better analgesic efficacy than the control group (P<0.01) with also better postpartum mental state (P<0.05). The observation group had shorter starting time of lactation and larger quantity of milk secretion (P<0.05) with higher prolactin level 48 h after delivery (P<0.05) than the control group. Conclusions Continuous epidural anesthesia and postpartum analgesia are effective and safe with little side effects in pain relief, improving the mental state, and promoting breast feeding. Obvious analgesic effect reduces catecholamine level, promotes prolactin secretion, and benefits the breast feeding.