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目的探讨腰麻-硬膜外联合麻醉(CSEA)分娩镇痛对产妇泌乳的影响。方法将360例无妊娠合并症、并发症及无乳腺发育缺陷及内分泌疾病的初产妇,按自愿原则分为对照组和观察组,每组180例。对照组按产科常规处理,产妇生产过程中不给予任何镇痛药物;观察组于生产过程中施行CSEA分娩镇痛。分别于产后24、48、72h测定血清泌乳素浓度,观察两组产妇产后开始泌乳时间及泌乳量,采用视觉模拟评分方法(VAS)评估镇痛效果。结果观察组宫缩时VAS评分显著低于对照组(均P<0.01);两组产妇产后血清泌乳素浓度、开始泌乳时间及泌乳量比较,差异无显著性意义(均P>0.05)。结论实施CSEA分娩镇痛可减轻产妇产时疼痛,且不会影响产后泌乳,有助于母乳喂养成功。
Objective To investigate the effect of spinal analgesia combined with epidural anesthesia (CSEA) on labor lactation on lactation in maternal. Methods 360 cases of pregnancy-related complications, complications and no birth defects and endocrine diseases of primipara, according to the principle of voluntary divided into control group and observation group, 180 cases in each group. The control group was routinely treated by obstetrics and gynecology. No analgesic drugs were given during the maternal production. The observation group was given CSEA analgesia during the production process. Serum prolactin concentrations were measured at 24, 48, and 72 h postpartum respectively. The lactation time and the amount of lactation after birth were observed in both groups. Visual analogue scale (VAS) was used to evaluate the analgesic effect. Results The VAS score in observation group was significantly lower than that in control group (all P <0.01). There was no significant difference in serum prolactin concentration, lactation time and milk yield between the two groups (all P> 0.05). Conclusion The implementation of CSEA labor analgesia can reduce the pain during delivery and will not affect the postpartum lactation, which will help breastfeeding success.