剖宫产术后病人自控硬膜外镇痛对血浆泌乳素的影响

目的探讨剖宫产术后病人自控硬膜外镇痛对血浆泌乳素的影响.方法选择80例健康足月产妇,择期在硬膜外麻醉下行剖宫产术.术毕随机分为两组,镇痛组(n=40)行病人自控硬膜外镇痛(PCEA),持续72小时(2 ml/h).对照组(n=40)术毕拔出硬膜外导管.两组采用化学发光免疫分析法测定血浆泌乳索(PRL)浓度.结果镇痛组视觉模拟评分(VAS)明显低于对照组(P＜0.01).两组术后PRL均较术前明显升高(P＜0.01),镇痛组术后PRL高于对照组,24小时差异具有显著性(P＜0.05),48小时差异具有极显著性(P＜0.01).相关分析表明镇痛组术后24小时与48小时VAS评分与血浆PRL浓度呈负相关性(P＜0.01).镇痛组初乳时间较对照组提前(P＜0.05).结论剖宫产术后病人自控硬膜外镇痛能促进PRL分泌,促进提前泌乳.

Effect of patient controlled epidural analgesia on plasma prolactin level after cesarean section

Objective:To study the effect of patient controlled epidural analgesia(PCEA) on plasma prolactin leval after cesarean section.Methods:Eighty healthy parturients at term undergoing elective cesaarean into two groups.Group I,40 cases of cesarean section received PCEA.Group II did not receive postoperative management.PCEA was performed for 72 hrs(2 ml/h).The plasma prolaction level was measured with radioimmunossay(RIA).Results:VAS paia score after operation was significantly lower in PCEA than in the control group(P<0.01).In both groups,prolactin levels were significantly higher after operation(P<0.01).The increase was greater in PPCEA group(P<0.05).There were negative correlations between VAS scores(24 h and 48 h postoperation)and the plasma concentration of prolaction(P<0.01).Lactation started earlier in PCEA group than in control group(P<0.05).Conclusion:PCEA after cesarean section prodused a satisfactory increased secretion of prolaction and improved colostrum.