蛛网膜下腔麻醉在剖宫产麻醉中的应用效果及对泌乳素、IL-10及循环系统的影响

摘要 目的：探讨蛛网膜下腔麻醉在剖宫产麻醉中的应用效果及对泌乳素、白细胞介素10（IL-10）及循环系统的影响。方法：选择2019年6月-2021年6月在我院接受治疗的120例剖宫产产妇，采用随机数表法分为试验组（n=61）和对照组（n=59）。对照组给予连续性硬膜外麻醉，试验组蛛网膜下腔麻醉。比较两组麻醉情况、泌乳素、IL-10、心率（HR）、收缩压（SBP）及舒张压（DBP）、去甲肾上腺素（NE）、肾上腺素（E）、多巴胺（DA）水平变化情况及不良反应发生情况。结果：试验组感觉阻滞起效、运动阻滞起效时间均显著低于对照组，感觉阻滞维持、运动阻滞维持时间均高于对照组（P<0.05）；术前，试验组和对照组血清泌乳素、IL-10比较无显著性差异；术后，试验组血清泌乳素、IL-10均高于对照组，具有显著性差异（P<0.05）；术前，试验组和对照组HR、SBP及DBP比较无显著性差异；术后，试验组和对照组HR、SBP及DBP均有所降低，两组间无显著性差异（P>0.05）；术前，两组应激反应水平无显著性差异；术后试验组和对照组NE、E、DA水平均有所升高，且试验组上述指标均显著低于对照组，具有显著性差异（P<0.05）；两组不良反应总发生率为4.92%、8.47%，无显著性差异（P>0.05）。结论：在剖宫产中应用蛛网膜下腔麻醉效果显著，可有效改善产妇泌乳素、IL-10水平。

Effect of Subarachnoid Anesthesia in Cesarean Section and Its Effect on Prolactin, IL-10 and Circulatory System

ABSTRACT Objective: To study Effect of subarachnoid anesthesia in cesarean section and its effect on prolactin, Interleukin 10 (IL-10) and circulatory system. Methods: 120 cesarean section patients treated in our hospital from June 2019 to June 2021 were selected and divided into experimental group (n=61) and control group (n=59) by random number table method. The control group received continuous epidural anesthesia, and the experimental group received subarachnoid anesthesia. Anesthesia, prolactin, IL-10, heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), norepinephrine (NE), epinephrine (E), dopamine (DA) levels and the occurrence of adverse reactions were compared between the two groups. Results: The onset time of sensory block and motor block in experimental group were significantly lower than those in control group, and the maintenance time of sensory block and motor block in experimental group were significantly higher than those in control group (P<0.05). Before operation, there were no significant differences in serum prolactin and IL-10 between experimental group and control group. After operation, serum prolactin and IL-10 in experimental group were significantly higher than those in control group (P<0.05); Before operation, there were no significant differences in HR, SBP and DBP between experimental group and control group. After operation, HR, SBP and DBP of experimental group and control group were decreased, but there were no significant differences between the two groups (P>0.05). Before surgery, there was no significant difference in stress response between the two groups. The levels of NE, E and DA in experimental group and control group were increased after operation, and the above indexes in experimental group were significantly lower than those in control group, the difference was significant (P<0.05); The total incidence of adverse reactions between the two groups was 4.92% and 8.47%, with no significant difference (P>0.05). Conclusion: Subaracheid anesthesia in cesarean section has significant effect and can effectively improve the levels of prolactin and IL-10.