七氟醚吸入联合地佐辛对妊娠期高血压产妇剖宫产时镇痛效果及对寒颤预防研究

doi:10.3969/j.issn.1006-6233.2018.12.001

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摘要 目的: 探讨七氟醚吸入联合地佐辛对妊娠期高血压产妇剖宫产时镇痛效果及对寒颤预防效果。方法: 选择2014年5月至2017年5月我院接诊的行剖宫产的妊娠期高血压产妇80例作为研究对象,以随机数表法分为观察组(n=45)和对照组(n=35),对照组使用七氟醚进行麻醉,并胎儿娩出后,给予曲马多静脉注射,观察组在对照组基础上,联合地佐辛静脉注射。比较两组麻醉后寒颤发生情况、采用视觉模拟评分法(Visual Analogue Scale/Score,VAS)对两组产妇术后各个时点静息和运动时进行评分评分、术后苏醒时间、躁动发生率及有效镇痛时间,记录两组不良反应发生情况。结果: 观察组产妇麻醉后寒颤发生率为8.89%,明显低于对照组的34.29%(P<0.05);两组产妇静息、活动时VAS评分均呈下降趋势,且观察组在术后4h、8h、12h、24h及48h均低于对照组,差异具有统计学意义(P<0.05);两组患者麻醉苏醒时间无明显差异;苏醒期躁动观察组发生率明显低于对照组(P<0.05);有效镇痛时间对照组明显小于观察组,差异具有统计学意义(P<0.05);观察组产妇不良反应发生率6.67%显著低于对照组的31.43%(P<0.05)。结论: 在妊娠期高血压产妇剖宫产时使用七氟醚吸入联合地佐辛镇痛效果显著,可有效预防麻醉后的寒颤发生率,安全有效,值得推广与运用。

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关键词 ：七氟醚, 地佐辛, 妊娠期高血压, 镇痛效果, 寒颤

Abstract：Objective: To explore the analgesic effect of sevoflurane inhalation combined with dizosin on parturients with gestational hypertension during cesarean section and the prevention effect of shivering. Methods: 80 cases of pregnant women with high blood pressure admitted to our hospital from May 2014 to May 2017 were selected as the study subjects. They were divided into observation group (n=45) and control group (n=35) by random number table method. The control group was anesthetized with sevoflurane, and after the birth of the fetus, tramadol was given intravenously, on the basis of the control group, and the observation group was injected with dezocin. The occurrence of shivering after anesthesia was compared between the two groups. Visual Analogue Scale/Score (VAS) was used to score the rest and exercise time, recovery time, incidence of restlessness and effective analgesia time at each time point after operation. The occurrence of adverse reactions in the two groups was recorded. Results: The incidence of cold war in the observation group was 8.89%, which was significantly lower than 34.29% in the control group (P<0.05). The VAS scores of both groups showed a decreasing trend in both maternal resting and activity, and the observation group was lower than the control group at 4h, 8h, 12h, 24h and 48h after surgery, and the difference was statistically significant (P<0.05). There was no significant difference between the two groups. The incidence of wakeful observation group was significantly lower than that in the control group (P<0.05). The effective analgesic time control group was significantly smaller than the observation group, and the difference was statistically significant (P<0.05). The incidence of adverse reactions in the observation group was 6.67%, which was significantly lower than that in the control group (P<0.05). Conclusion: Sevoflurane inhalation combined with diazoxin during caesarean section in hypertensive women during pregnancy has a significant analgesic effect and can effectively prevent the incidence of cold war after anesthesia. It is safe and effective and worthy of promotion and application.

Key words： Sevoflurane Diazoxin Gestational hypertension Analgesic effect Chills

基金资助:辽宁省自然科学基金项目,(编号:201202233)

通讯作者: 张丽红

引用本文:

张亭亭,姚明龙,蔡恒宇,汪祉琳,张丽红. 七氟醚吸入联合地佐辛对妊娠期高血压产妇剖宫产时镇痛效果及对寒颤预防研究[J]. 河北医学, 2018, 24(12): 1937-1940.
ZHANG Tingting, YAO Minglong, CAI Hengyu, et al. Analgesic Effect of Sevoflurane Inhalation combined with Dizosin on Parturients with Gestational Hypertension during Cesarean Section and Prevention of Shivering. HeBei Med, 2018, 24(12): 1937-1940.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2018.12.001 或 http://www.hbyxzzs.cn/CN/Y2018/V24/I12/1937

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