摘要
目的:探讨妊娠期糖尿病(gestational diabetes mellitus,GDM)剖宫产术后患者采用罗哌卡因联合氢吗啡酮硬膜外自控镇痛的效果。方法:选取2018年1月-2020年10月阳新县人民医院收治的剖宫产手术GDM患者104例,采取随机数字表法分为对照组和观察组,各52例。对照组在剖宫产术后给予双氯芬酸钠栓剂,观察组给予罗哌卡因联合氢吗啡酮硬膜外自控镇痛,两组均干预2 d。对比两组干预前后的疼痛程度、胃肠激素、应激激素、炎症介质,对比两组术后12、24、48 h的血糖波动情况。结果:两组干预2 d后的VAS评分、血清单核细胞趋化因子蛋白-1(monocyte chemoattractant protein-1,MCP-1)、白介素-6(interleukin-6,IL-6)、高迁移率族蛋白B1(high mobility group box 1 protein,HMGB-1)水平均低于干预前,且观察组均低于对照组(P<0.05);干预2 d后两组血清血管活性肠肽(vasoactine intrestinal peptide,VIP)、胆囊收缩素(cholecystokinin,CCK)、醛固酮(aldosterone,ALD)、皮质醇(cortisol,Cor)、血管紧张素Ⅱ(angiotensin Ⅱ,AngⅡ)及去甲肾上腺素(norepinephrine,NE)水平均高于干预前,而观察组均低于对照组(P<0.05);干预2 d后两组血清胃动素(motilin,MTL)、胃泌素(gastrin,GAS)水平均低于干预前,而观察组均高于对照组(P<0.05);观察组术后12、24、48 h的血糖水平均低于对照组(P<0.05)。结论:GDM剖宫产术后患者采用罗哌卡因联合氢吗啡酮硬膜外自控镇痛可有效改善其胃肠功能,减轻疼痛和应激反应,同时可抑制机体炎症反应,改善血糖水平,效果显著。
Objective:To investigate the effect of Ropivacaine combined with Hydromorphone epidural patient-controlled analgesia in patients with gestational diabetes mellitus (GDM) after cesarean section.Method:A total of 104 GDM patients who received cesarean section in Yangxin County People’s Hospital from January 2018 to October 2020 were selected and they were divided into control group and observation group by random-number table method,52 cases in each.The control group was given Diclofenac Sodium Suppositories after cesarean section,and the observation group was given Ropivacaine combined with Hydromorphone epidural patient-controlled analgesia,intervention for 2 days in both groups.The pain degree,gastrointestinal hormones,stress hormones and inflammatory mediators were compared between the two groups before and after intervention.Blood glucose fluctuations of the two groups were compared 12,24 and 48 h after surgery.Result:The levels of VAS scores,serum monocyte chemoattractant protein-1 (MCP-1),interleukin-6 (IL-6),and high mobility group box 1 protein (HMGB-1) of the two groups after the intervention of 2 d were lower than those before the intervention,and the indexes in the observation group were lower than those in the control group (P<0.05).The serum levels of vasoactive intestinal peptide (VIP),cholecystokinin (CCK),aldosterone (ALD),cortisol (Cor),angiotensinⅡ (AngⅡ) and norepinephrine (NE) in the two groups after intervention of 2 d were higher than those before intervention,while which in the observation group were lower than those in the control group (P<0.05).After intervention of 2 d,the levels of serum motilin (MTL) and gastrin (GAS) in two groups were lower than those before intervention,while which in the observation group were higher than those in the control group (P<0.05).The blood glucose levels of the observation group were lower than those of the control group at 12,24 and 48 hours after surgery (P<0.05).Conclusion:Patient-controlled epidural analgesia with Ropivacaine combined with Hydro
作者
陈全福
张剑飞
CHEN Quanfu;ZHANG Jianfei(Yangxin County People’s Hospital,Yangxin 435200,China)
出处
《中外医学研究》
2022年第19期40-44,共5页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
妊娠期糖尿病
剖宫产
罗哌卡因
氢吗啡酮
硬膜外自控镇痛
单核细胞趋化因子蛋白-1
Gestational diabetes mellitus
Cesarean section
Ropivacaine
Hydromorphone
Epidural patient-controlled analgesia
Monocyte chemoattractant protein-1
