The influence of different analgesia methods on blood coagulation state of gestational hypertension patients after cesarean section
Objective To study the effect of doting state of PCEA and PCIA on gestational hypertension patients after cesarean section and the significance in the prevention of thrombosis. Methods 60 cases ASA Ⅱ- Ⅲ patiens with the pregnancy-induced hypertension after surgical cesarean section in Qingzhou People's Hospital were selected and randomly divided into three groups, P group for epidural anesthanalg group (P group, n = 20); V group for vein anesthanalg group (Ⅴ group, n = 20) and C group for unused postoperative analgesia group (C group,n = 20). Three groups epidural catheter were all placed at L2-3 interspace and 2 % lidocaine was given during operation. After operation P group PCEA was commenced with 0. 15% ropivacaine and morphine 40 μg/ml (background infusine 2 ml/h, bolus dose 1 ml, lockout interval 15 minutes). Postoperatively V group was placed on PCIA with morpine 0.5 mg/ml (background infusine 1 ml/h, bolus dose 2 ml, lockout interval 15 min). Record the VAS score and the Ramsay score after 3, 12, 24, and 36 and 48 hours of three groups maternal. Blood sampales were taken before anesthesia, and 12 h, 24 h, 48 h after operation. Compare the changes of these indexes of plasma prothrombin time (PT), activated partial thromboPlastin time (APTT), thrombin time (TT), fibrinogen (Fib), D dimers(DD) in preoperative and postoperative 12 h, 24 h, 48 h the difference in and among the groups. Observe the change of coagulation state of puerperal. Research the influence of blood clots state about PCEA and PCIA on gestational hypertensive patients after cesarean section, and the clinical significance to take precautions against thrombosis of pregnancy uteruses hypertension patients after cesarean section. Results PT of postoperative P group was significantly longer than V group and C group, there was a statistically significant (P<0.05) :APTT in postoperative 12 and 24 hours, P group was significantly longer than V group and group C (P<0. 05); After operation among groups of each date, the contents of P group were more lower than V and C group, the difference was statistically significant (P<0. 05). There was not statistics difference between V and C group(P>0.05). Conclusions PCEA can restrain the high pour point state of gestational hypertension patients after cesarean section, and has a protective effect to the postoperative thrombosis; PCIA has not asignificantly affect on high pour point state of gestational hypertension patients after cesarean section.
NETL
NSTL
万方数据
维普
