摘要
目的探讨舒芬太尼和维生素C联用对妊娠期高血压疾病产妇剖宫产术后机体氧化应激和炎症水平的影响及临床应用效果。方法选取2019年1月—2022年12月舟山市妇女儿童医院收治的60例妊娠期高血压疾病产妇为研究对象,根据术后用药分为A组(对照组,20例)、B组(舒芬太尼组,20例)及C组(舒芬太尼+维生素C组,20例),回顾性对比分析舒芬太尼和维生素C联用对机体氧化应激和炎症水平的影响及临床应用效果。结果T0时,3组产妇收缩压、丙二醛(MDA)、超氧化物歧化酶(SOD)、白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)水平比较,差异均无统计学意义(均P>0.05)。T1时,B组产妇收缩压与A组比较,差异无统计学意义(P>0.05);C组产妇收缩压显著低于B组,差异有统计学意义(P<0.05)。T2和T3时,B组产妇收缩压显著低于A组,差异均有统计学意义(均P<0.05),C组产妇收缩压均显著低于B组,差异均有统计学意义(均P<0.05)。T1、T2及T3时,B组产妇MDA水平均低于A组,差异均有统计学意义(均P<0.05);C组产妇MDA水平均显著低于B组,差异均有统计学意义(均P<0.05)。T1、T2及T3时,B组产妇SOD水平均高于A组,差异均有统计学意义(均P<0.05);C组产妇SOD水平均显著高于B组,差异均有统计学意义(均P<0.05)。T1、T2及T3时,B组产妇IL-6水平均显著低于A组,差异均有统计学意义(均P<0.05);C组产妇IL-6水平均显著低于B组,差异均有统计学意义(均P<0.05)。T1、T2及T3时,B组产妇TNF-α水平均显著低于A组,差异均有统计学意义(均P<0.05);C组产妇TNF-α水平均显著低于B组,差异均有统计学意义(均P<0.05)。术后48 h,B组产妇VAS评分[(2.2±0.3)分]低于A组[(3.4±0.6)分],C组产妇疼痛VAS评分[(0.8±0.2)分]低于B组,差异均有统计学意义(t=1.00、1.20,均P<0.05)。B组产妇伤口愈合程度评分[(2.3±0.4)分]与A组[(2.1±0.3)分]比较,差异无统计学意义(t=0.10,P>0.05)。C组产妇伤口愈合程度评分[(3.7±0.4)分]明显高于B组,差异有统计学意义(t=1.20,P<0.05)。结论舒芬太尼和维生素C联合用于妊娠期高血压疾病产妇剖宫产术中,能显著降低产妇术后血压、降低机体氧化应激及炎症水平,且术后产妇疼痛明显减轻,伤口愈合程度显著加快,对术后产妇的快速康复具有重要临床价值。
Objective To investigate the effects of sufentanil combined with vitamin C on oxidative stress and inflammation levels of pregnant women with hypertensive diseases after cesarean section and its clinical application.Methods A total of 60 pregnant women with hypertensive diseases during pregnancy admitted to Zhoushan Women and Children's Hospital from January 2019 to December 2022 were selected as the study objects.According to postoperative medication,they were divided into group A(control group,20 cases),group B(sufentanil group,20 cases),and group C(sufentanil+vitamin C group,20 cases).The effects of combination of sufentanil and vitamin C on oxidative stress and inflammation and the clinical effects were retrospectively analyzed.Results There were no statistically significant differences in systolic blood pressure,malondialdehyde(MDA),superoxide dismutase(SOD),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)levels among 3 groups at TO stimulation(P>0.05).At T1,the systolic blood pressure in group B was not statistically significant compared with group A(P>0.05);The systolic blood pressure in group C was significantly lower than that in group B(P<0.05).The systolic blood pressure in group B was significantly lower than those in group A at T2 and T3(all P<0.05),and the systolic blood pressure in group C was significantly lower than that in group B(P<0.05).The MDA levels in group B were lower than those in group A at TI,T2 and T3,and the differences were statistically significant(all P<0.05).The MDA levels in group C were significantly lower than those in group B,and the differences were statistically significant(all P<0.05).The SOD levels in group B were higher than those in group A at T1,T2 and T3,and the differences were statistically significant(all P<0.05).The levels of SOD in group C were significantly higher than those in group B,and the differences were statistically significant(all P<0.05).The IL-6 levels in group B were significantly lower than those in group A at T1,T2 and T3,and the differences were statistically significant(all P<0.05).IL-6 levels in group C were significantly lower than those in group B,and the differences were statistically significant(all P<0.05).The TNF-alevels in group B were significantly lower than those in group A at T1,T2 and T3,and the differences were statistically significant(all P<0.05).The levels of TNF-αin group C were significantly lower than those in group B,and the differences were statistically significant(all P<0.05).48 h after operation,the VAS score[(2.2±0.3)score]in group B was lower than that in group A[(3.4±0.6)score],and the VAS score[(0.8±0.2)score]in group C was lower than that in group B,the differences were statistically significant(t=1.00,1.20,all P<0.05).There was no significant difference in wound healing degree between group B[(2.3±0.4)score]and group A[(2.1+0.3)score](t=0.10,P>0.05).The wound healing degree scorein group C[(3.7±0.4)score]was significantly higher than that in group B,and the dfference was statistically significant(t=1.20,P<0.05).Conclusion The combination of sufentanil and vitamin C in cesarean section of pregnant women with hypertensive diseases can significantly reduce the blood pressure after delivery,reduce the level of oxidative stress and inflammation of the body,and significantly reduce the postoperative pain and wound healing,which has important clinical value for the rapid recovery of postoperative parturients.
作者
邵满芬
高宝斌
屈百鸣
沈凯
SHAO Man-fen;GAO Bao-bin;QU Bai-ming;SHEN Kai(不详;Department of Anesthesiology,Zhoushan Women and Children's Hospital,Zhoushan,Zhejiang 316000,China)
出处
《中国妇幼保健》
CAS
2023年第19期3621-3625,共5页
Maternal and Child Health Care of China
基金
浙江省医学会临床科研基金项目(2022ZYC-Z38)。
关键词
妊娠期高血压疾病
剖宫产
舒芬太尼
维生素C
Hypertensive diseases during pregnancy
Caesarean section
Sufentanil
Vitamin C
作者简介
通信作者:沈凯,E-mail:sk-555@163.com。
