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目的观察小剂量罗哌卡因复合舒芬太尼不同麻醉方式用于无痛分娩对母婴血清皮质醇及一氧化氮(NO)水平的影响。方法收集2012年3月-2014年12月来医院分娩的初产妇248例,随机分为观察组和对照组各124例。2组患者麻醉药物均为0.1%罗哌卡因复合舒芬太尼,观察组选择腰硬联合麻醉,对照组选择硬膜外麻醉。分别于分娩前后抽取产妇静脉血及新生儿娩出后脐静脉血,检测血清皮质醇和NO差异。结果观察组分娩后母婴血清皮质醇持续降低,而对照组上升,且对照组分娩后母婴血清NO水平持续降低,差异均有统计学意义(P<0.05);观察组分娩后NO水平无明显变化,差异无统计学意义(P>0.05)。结论腰硬联合麻醉无痛分娩对母婴血清皮质醇及NO水平的影响较硬膜外麻醉理想。
Objective To observe the effect of different doses of ropivacaine combined with sufentanil on serum cortisol and nitric oxide (NO) in painless childbirth. Methods 248 primipara from March 2012 to December 2014 were randomly divided into observation group (124 cases) and control group (124 cases). Patients in both groups were anesthetized with 0.1% ropivacaine and sufentanil. The observation group was given epidural anesthesia, while the control group was given epidural anesthesia. Before and after childbirth, maternal venous blood and umbilical venous blood were collected after delivery, and serum cortisol and NO levels were measured. Results The serum levels of cortisol in maternal and neonatal rats kept decreasing in the observation group and increased in the control group, while the serum levels of maternal and neonatal rats in the control group continued to decrease after delivery (P <0.05). The levels of NO in the observation group after delivery Significant changes, the difference was not statistically significant (P> 0.05). Conclusion The effect of combined spinal pain and painless labor on maternal serum cortisol and NO levels is better than that of epidural anesthesia.