不同镇痛方式对剖宫产产妇血液黏度及子宫收缩情况的影响比较

李春娟

【摘要】 目的：探讨不同镇痛方式对剖宫产产妇的血液黏度及子宫收缩情况的影响。方法：选取2018年12月-2020年8月于本院行剖宫产术的产妇86例，按随机数字表法分为对照组和观察组，各43例。对照组行连续硬膜腔外阻滞麻醉，观察组行蛛网膜下隙联合硬膜腔外阻滞麻醉。比较两组镇痛效果、宫缩持续时间、宫缩间隔时间及血液黏度。结果：观察组疼痛Ⅰ级与Ⅱ级比例均高于对照组，且Ⅲ级与Ⅳ级比较均低于对照组（P<0.05）。术后30、60 min，观察组宫缩持续时间均短于对照组，且平均宫缩间隔时间均长于对照组（P<0.05）。麻醉5 min后及胎儿娩出后30 min观察组全血黏度、全血还原黏度、血浆黏度、纤维蛋白原及红细胞聚集指数均低于对照组（P<0.05）。结论：对剖宫产产妇行蛛网膜下隙联合硬膜腔外阻滞麻醉，镇痛效果更佳，有效缩短宫缩持续时间，延长宫缩间隔时间，降低血液黏度，减轻产妇痛苦。

【关键词】 剖宫产 镇痛 血液黏度 子宫收缩

[Abstract] Objective： To investigate the effects of different analgesia methods on blood viscosity and uterine contractions of parturients with cesarean section. Method： A total of 86 parturients underwent cesarean section in our hospital from December 2018 to August 2020 were selected. They were divided into control group and observation group according to random number table method， 43 cases in each group. The control group received continuous epidural block anesthesia， and the observation group received subarachnoid space combined with epidural block anesthesia. The analgesic effect， duration of contractions， interval of contractions time and blood viscosity were compared between two groups. Result： The proportion of grade Ⅰ and grade Ⅱ pain in the observation group were higher than those in the control group， and the grade Ⅲ and grade Ⅳ pain in the observation group were lower than those in the control group （P<0.05）. 30 and 60 min after operation， the duration of contractions in the observation group was shorter than that in the control group， and the average interval of contractions time in the observation group was longer than that in the control group （P<0.05）. 5 min after anesthesia and 30 min after fetal delivery， the whole blood viscosity， whole blood reducing viscosity， plasma viscosity， fibrinogen and erythrocyte aggregation index of the observation group were lower than those of the control group （P<0.05）. Conclusion： Subarachnoid anesthesia combined with epidural anesthesia for cesarean section women has a better analgesic effect， can effectively shorten the duration of contractions， prolong the interval of contractions time， reduce blood viscosity and the pain of parturients.

[Key words] Cesarean section Analgesia Blood viscosity Uterine contraction

First-authors address： Haicheng City Central Hospital， Haicheng 114200， China

doi：10.3969/j.issn.1674-4985.2021.09.012

剖宮产是孕妇在分娩的过程中，由于孕妇或胎儿的原因，无法使婴儿顺利地自然降生而由医生采取开刀手术切开产妇腹部及子宫，取出胎儿的一种方法[1-2]。剖宫产可以避免因自然分娩可能对胎儿或产妇生命及健康造成的损害。近年来，随着二孩政策的开放，产妇数量明显增加，高危产妇的比例也有所增长，行剖宫产的产妇数量随之增加[3-4]。但剖宫产术后宫缩疼痛和切口疼痛都是产妇和家属较为关心的问题，也是临床中常见需要进一步深入研究的课题[5-6]。本研究对产妇进行不同方式的镇痛，观察剖宫产术后产妇的血液黏度和子宫收缩情况，以为临床提供较好的参考价值，现报道如下。

1 资料与方法

1.1 一般资料 选取2018年12月-2020年8月于本院行剖宫产术的产妇86例作为研究对象。纳入标准：足月单胎;符合剖宫产术指征。排除标准：先兆子痫和妊娠高血压综合征;严重肝肾疾病;有硬膜外穿刺禁忌证。按随机数字表法将产妇分为对照组和观察组，各43例，所有产妇及家属均知情同意并签署知情同意书，本研究已经医院伦理委员会批准。……