目的探讨硬膜外自控镇痛对剖宫产术后患者的感染控制及微循环状态的影响。方法选择我院2008年6月~2014年2月产科收治的206例行剖宫产产妇，按照患者对麻醉方式自愿原则，采用硬膜外自控镇痛产妇110例作为观察组，采用肌肉注射盐酸哌替啶镇痛产妇96例作为对照组，以产妇体温恢复情况、白细胞正常作为观察指标，分析两组产妇第3、第5、第7d切口感染的控制情况，统计分析两组产妇生产前后24、48h微循环相关指标变化。结果第3、5、7d观察组体温恢复率分别为83.64%（92/110）、10.91%（12/110）、5.45%（6/110）；对照组分别为41.67%（40/96）、47.92%（46/96）、10.42%（10/96），两组比较差异显著（P<0.05），两组白细胞正常变化比较有统计学差异（P<0.05）；生产前两组患者微循环指标比较无统计学差异（P>0.05），治疗后24、48h比较观察组管襻长度、襻顶宽度与对照组比较均明显增大（P<0.05），管襻形态积分、总积分低于对照组，差异比较有统计学意义（P<0.05），生产后24、48h血液黏度指标两组比较均有明显差异性（P<0.05）。结论硬膜外自控镇痛可以有效降低剖宫产产妇术后的感染率，改善产妇微循环状态，对产妇术后各项功能恢复具有推进作用，是一种产科病房值得采用的术后镇痛方式。%Objective To explore the effect of epidural controlled analgesia in the infection control and microcirculation state for patients with cesarean section. Methods 206 cases of cesarean sec-tion in our hospital from June 2008 to February 2014 were chosen. According to the voluntary principles on anesthesia, the patients with anesthesia way using epidural controlled analgesia were as the observation group of 110 cases, and the muscle injection of pethidine hydrochloride anal-gesia was as the control group of 96 cases. The maternal body temperature recovery, normal white blood cells were as the observation indexes. The incision infection control situation for the two groups of 3 days, 5 days and 7 days were taken for analysis. The change of microcirculation in-dicators 24 hours and 48 hours before maternal production were taken for statistical analysis. Re-sults The temperature recovery rates of the observation group of 3 day, 5 days, and 7 days were 83.64%(92/110),10.91%(12/110),5.45%(6/110), and the control group were 41.67% (40/96), 47.92%(46/96),10.42%(10/96).Compared between the two groups, there were significant differences(P<0.05). The comparisons of the normal changes for the white blood cells of the two groups were also with statistical significance (P<0.05). The circulation indexes of the two groups before production were without statistical difference (P>0.05). The tube loop length and loop top width 24 hours and 48 hours after treatment of the observation group compared with the control group, there were signifi-cantly increased (P<0.05), and the tube loop form integral, total score was lower than the control group, and the differences compared were statistical significance (P<0.05). The blood viscosity in-dexes 24 hours and 48 hours after production compared between the two groups were with signif-icant differences(P<0.05). Conclusion Epidural controlled analgesia can effectively reduce the rate of infection after cesarean section, and improve maternal microcirculation status, to promote the functional recovery. It is a kind of maternity ward, and it is worthy of postoperative analgesia.
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