CAJ | 학술논문

目的：观察静脉输注硫酸镁对子痫前期重度产妇剖宫产术后镇痛效果的影响。方法选择本院2013年1月~2014年12月收治的子痫前期重度行剖宫产的产妇200例，将其随机分为观察组和对照组，每组100例。观察组围术期使用硫酸镁跃2 d，每日用量跃15 g，而对照组产妇则不使用硫酸镁。两组均在鞘内注入1%罗哌卡因1.0~1.2 ml行腰-硬联合麻醉，待胎儿取出缝合腹膜后，在硬膜外腔给予吗啡2.0 mg，然后接PCA镇痛泵，泵内药液为0.125%盐酸罗哌卡因和0.00004%吗啡(含吗啡4 mg)共计100 ml，负荷量为5 ml，背景剂量2 ml/h，单次给药剂量(bolus)为1.0 ml，锁定时间为15 min。观察两组的术后镇痛效果、产妇舒适度，并观察恶心呕吐、皮肤瘙痒及尿潴留的发生率；观察血镁与皮质醇的变化。结果观察组产妇的镇痛效果和舒适度均显著优于对照组(P<0.01)，而恶心呕吐、皮肤瘙痒及尿潴留的发生率也低于对照组(P<0.05)。在一定范围内，血镁的浓度与患者的疼痛程度成反比关系。结论静脉输注硫酸镁可减轻子痫前期重度产妇的术后疼痛，降低其恶心呕吐、皮肤瘙痒及尿潴留的发生率，提高产妇的舒适度。
목적：관찰정맥수주류산미대자간전기중도산부부궁산술후진통효과적영향。방법선택본원2013년1월~2014년12월수치적자간전기중도행부궁산적산부200례，장기수궤분위관찰조화대조조，매조100례。관찰조위술기사용류산미약2 d，매일용량약15 g，이대조조산부칙불사용류산미。량조균재초내주입1%라고잡인1.0~1.2 ml행요-경연합마취，대태인취출봉합복막후，재경막외강급여마배2.0 mg，연후접PCA진통빙，빙내약액위0.125%염산라고잡인화0.00004%마배(함마배4 mg)공계100 ml，부하량위5 ml，배경제량2 ml/h，단차급약제량(bolus)위1.0 ml，쇄정시간위15 min。관찰량조적술후진통효과、산부서괄도，병관찰악심구토、피부소양급뇨저류적발생솔；관찰혈미여피질순적변화。결과관찰조산부적진통효과화서괄도균현저우우대조조(P<0.01)，이악심구토、피부소양급뇨저류적발생솔야저우대조조(P<0.05)。재일정범위내，혈미적농도여환자적동통정도성반비관계。결론정맥수주류산미가감경자간전기중도산부적술후동통，강저기악심구토、피부소양급뇨저류적발생솔，제고산부적서괄도。
Objective To observe the influence of intravenous infusion of magnesium sulfate on analgesia effect after cesarean section for puerpera with severe pre-eclampsia. Methods 200 puerperae with severe pre-eclampsia given ce-sarean section treated in our hospital from January 2013 to December 2014 were selected,and they were randomly di-vided into observation group (n=100) and control group(n=100).Observation group was given magnesium sulfate for more than 2 days,daliy dose was more than 15 g,while control group was not given magnesium sulfate.Both groups were given intrathecal injection 1% ropivacaine of 1.0-1.2 ml for combined spinal-epidural anesthesia. After the fetal disengage-ment and the peritoneum was sutured,2.0 mg morphine was infused in the epidural space,then PCA analgesia pump was connected,and the liquid in the pump was 0.125% ropivacaine and morphine 0.000 04% (containing morphine 4 mg) coming to 100 ml,the load quantity was 5 ml, background dose was 2 ml/h,single dose of medicament (bolus) was 1 ml, the lock time was 15 min.Analgesic effect after operation and comfort degree of puerpera,and the incidence rate of nau-sea and vomiting, skin pruritus and urinary retention,change of blood magnesium and cortisol in two groups was com-pared respectively. Results The analgesic effect and comfort degree of observation group was significantly better than that of the control group respaetively (P<0.01),while the incidence rate of nausea and vomiting,skin pruritus and urinary retention was also lower than that of control group (P<0.05).In a certain range,the concentration of serum magnesium was inversely proportional to the pain degree of the patients. Conclusion Intravenous infusion of magnesium sulfate can relieve the postoperative pain and reduce the incidence rate of nausea and vomitting,skin pruritus and urinary reten-tion,and improve the comfort degree of puerpera.