硬膜外自控镇痛泵用于剖宫产术后的临床观察

目的 观察硬膜外自控镇痛泵用于剖宫产术后的镇痛效果及其对母婴的影响.方法 选择硬膜外麻醉剖宫产术产妇200例,随机分观察组和对照组各100例,观察组术毕接镇痛泵行硬膜外自控镇痛（Patient controlled epidural analgesia,PCEA）48h拔管,对照组术毕即拔管,术后未给任何药物,观察两组术后镇痛效果,肛门排气时间,拔尿管后排尿情况,产后出血情况,产妇泌乳,母乳喂养,新生儿体重丢失及早期新生儿黄疸情况.结果 观察组镇痛效果显著好于对照组;两组产妇肛门排气时间,拔尿管后排尿情况,产后出血情况无明显差别.术后24h内开始泌乳、哺乳次数多于10次的例数均显著多于对照组（P＜0.01）;观察组新生儿早期高胆红素血症的发生率、体重丢失超重发生率均显著低于对照组（P＜0.01）.结论 剖宫产术后PCEA不但能产生良好的镇痛效果,不延长肛门排气时间,不影响拔尿管后排尿情况,不增加产后出血量,还有助于增加母乳喂养次数,提高母乳喂养的成功率,减少新生儿早期因哺乳不足而出现的并发症.

Clinical observation of the effect of Patient Controlled Epidural Analgesia after cesarean section

Objective To observe the clinical effects of Patient Controlled Epidural Analgesia on both mother and neonate after cesarean section. Methods 200 postoperative patients were randomly divided into PCEA group and control group. After the operation, the PCEA was joined to the tube of epidural analgesia and preserved for 48 hours in the study group .Compare the effect of pain-alleviating,exsufflotion ,urinary retention,postpartum haemorrhage,lactation ,breast-feeding ,the loss of neonate body weight and the early jaundice of neonate. Results In the observing group, the patient reported much less pain, early lactation, and better breast-feeding, and the neonate have less occurrence of hyperbilirubinemia , and less body weight loss. There were no remarkable differences between two groups in the incidence of exsufflation urinary retention and postpartum haemorrhage. Conclusion patient controlled epidural analgesia not only have excellent analgesic effect and little influence on urinary retention and postpartum haemorrhage, but also is related to early lactation, increase frequence of breast-feeding, improve the success rate of breast-feeding, it may avoid the consequence of under-lactation.