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目的:探讨不同镇痛方法对剖宫术后产妇血清中泌乳素(PRL)的影响。方法:根据镇痛方法的不同,将300例产妇随机分为三组:Ⅰ组为术后根据临床需要临时给予哌替啶50 mg肌内注射;Ⅱ组采用罗哌卡因加芬太尼持续硬膜外镇痛;Ⅲ组采用芬太尼持续静脉镇痛。分别于剖宫术结束时、术后2、24及48 h抽取产妇静脉血,测定血清PRL,并观察镇痛效果及哺乳情况。结果:在剖宫术结束时三组产妇血清PRL无明显差异;术后2、24及48 h,Ⅱ组和Ⅲ组产妇血清PRL值显著高于Ⅰ组(P<0.05)),并以Ⅱ组更为明显(P<0.05)。结论:剖宫术后持续硬膜外镇痛及静脉镇痛均可增加PRL的分泌,尤其以硬膜外镇痛更有效,有利于早期哺乳。
Objective: To investigate the effect of different analgesic methods on prolactin (PRL) in maternal serum after cesarean section. Methods: According to the different methods of analgesia, 300 pregnant women were randomly divided into three groups: group Ⅰ was treated with intraperitoneal injection of pethidine 50 mg according to clinical need; group Ⅱ was treated with ropivacaine plus fentanyl Epidural analgesia; group Ⅲ fentanyl sustained intravenous analgesia. At the end of cesarean section, 2, 24 and 48 h postoperatively, maternal venous blood was drawn and the serum PRL was measured. The analgesic effect and breastfeeding status were observed. Results: At the end of cesarean section, there was no significant difference in PRL among the three groups. Serum PRL of group Ⅱ and group Ⅲ were significantly higher than that of group Ⅰ (P0.05) at 2, 24 and 48 h after operation. Group was more obvious (P <0.05). Conclusion: Continuous epidural analgesia and intravenous analgesia after cesarean section can increase the secretion of PRL, especially in the more effective epidural analgesia, is conducive to early lactation.