| 摘要: |
| 目的 观察氟比洛芬酯复合丁丙诺啡和单用丁丙诺啡对子痫前期患者剖宫产术后静脉自控镇痛（PCIA）的临床效果和
应用价值。方法 选择90例ASAⅠ～Ⅱ级在腰硬联合麻醉下行子痫前期剖宫产术患者，按随机数字表法分为A组（胎儿娩出后氟比洛芬酯+术后丁丙诺啡PCIA）、B 组（术后氟比洛芬酯+丁丙诺啡PCIA）和C 组（术后丁丙诺啡PCIA），每组30例。观察并记录患者术后1、2、4、12、24h 视觉模拟评分（VAS）、Ramassay镇静评分，平均动脉压（MAP）、心率（HR）及术后恶心、呕吐、嗜睡、皮肤瘙痒等不良反应发生情况，分别于麻醉前、术后4、12 和24h抽取静脉血，检测血清肾上腺素、去甲肾上腺素、多巴胺、血浆儿茶酚胺和内皮素的水平。结果 A 组和B组患者术后各时点VAS 评分均明显低于C组（P＜0.05），A 组和B 组各时点Ramsay 镇静评分均明显高于C组（P＜0.05）；A 组和B 组术后各时点MAP 和HR 均明显低于C 组（P＜0.05）；术后24h 内PCIA 按压次数A 组和B 组明显低于C组（P＜0.05）；A 组和B 组术后各时点血清肾上腺素、去甲肾上腺素、多巴胺和内皮素水平均明显低于C 组（均P＜0.05）；A 组术后4h 内皮素水平明显低于B 组（P＜0.05）；A 组和B 组头晕、嗜睡、恶心、呕吐发生率均低于C 组（均P＜0.05）。结论 氟比洛芬酯能有效抑制术后应激，镇痛效果好且不良反应少，在胎儿娩出后应用氟比洛芬酯并结合术后丁丙诺啡进行PCIA更适合用于子痫前期剖宫产术后患者术后镇痛。 |
| 关键词: 氟比洛芬酯 静脉自控镇痛 剖宫产 子痫前期 |
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| Efficacy of flurbiprofen axetil in patient-controlled intravenous analgesia for preeclampsia patients after cesarean section |
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SHAO Zhiqiang,CHEN Xinzhong,SONG Xiaofeng,WANG Zhigang,LU Lihua,ZHOU Lipeng
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Fuyang Maternal and Child Health Hospital
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| Abstract: |
| Objective To evaluate the efficacy of flurbiprofen axetil in patient-controlled intravenous analgesia (PCIA) for preeclampsia patients after cesarean section. Methods Ninety preeclampsia patients undergoing caesarean section were randomly assigned to one of the three groups (n=30 in each): group A (flurbiprofen axetil i.v and PCIA with buprenorphine), group B (PCIA with flurbiprofen axetil and buprenorphine) and group C (PCIA with buprenorphine). The VAS scores and Ramsay sedation scores at 1h, 2h, 4h, 12h and 24h after operation were assessed, mean artery pressure, HR , adverse reaction were recorded,the serumlevel of adrenaline(E), noradrenaline(NE), dopamine(DA) and ET-1 level was detected, Results VAS scores of group A and group B at 1h, 2h, 4h, 12h and 24h after operation were significantly lower than those in groupsC (P＜0.05), Ramsay sedation scores of group A and group B at 1h, 2h, 4h, 12h and 24h after operation were significantly higher than those in groups C
(P＜0.05); 24h PCIA pressing times of group A and group B were significantly lower than that in groups C(P＜0.05); serumE, NE,DA and ET-1 levels of group A and group B were lower than those of group C (all P＜0.05). ET-1 level at 4h after operation of group A were lower than that of group B (P＜0.05). The incidence of dizziness, drowsiness, nausea and vomiting in group A and groups B were significantly lower than that in group C all P＜0.05). Conclusion Intravenous infusion of flurbiprofen axetil during the delivery can effectively inhibit postoperative stress with good analgesia effect and few adverse reactions, which is suitable for postoperative analgesia in preeclampsia patients undergoing cesarean section. |
| Key words: Flurbiprofen axetil Patient-controlled intravenous analgesia Caesarean section Preeclampsia |
