目的 对比使用吗啡栓剂与双氯芬酸钠栓剂缓解剖宫产术后护理过程中疼痛的效果与不良反应.方法 纳入50例18～40岁选择性剖宫产术后产妇,随机分为2组(吗啡栓剂组25例,双氯芬酸钠组25例,分别于返回病房后接受10 mg吗啡栓剂或100 mg双氯芬酸治疗.主要结局指标:使用数值疼痛评定量表评价产妇疼痛情况,用药后每隔2 h(用药后12 h内)~4 h(用药后12~24 h内)重复测量1次.次要结局指标包括产妇不良反应、新生儿不良反应、医患满意度.结果 49例产妇完成试验.用药后12 h内,吗啡栓剂组患者疼痛指数显著高于双氯芬酸钠组(7.32±1.67 vs.2.59±0.86,P=0.041),但此差异在用药后12~24 h内消失.两组患者均出现少量不良反应,包括恶心、尿潴留,但症状轻微.新生儿无任何不良反应报道.医患满意度较好.结论 剖宫产术后疼痛用药中,双氯芬酸钠栓剂在用药后0~12 h镇痛效果比吗啡栓剂更具优势.双氯芬酸钠栓剂与吗啡栓剂的不良反应均较少,可控.%Objective To compare the efficacy and adverse reactions between morphine suppository (MS) and diclofenac suppository (DS) for relieving post-cesarean pain.Methods Totally 50 consecutive subjects aged 18~40 years old with term pregnancies undergoing cesarean section receiving similar anesthesia and surgical technique participated in this trial.They were randomized into MS group(n=25) or DS group (n=25) to receive 10 mg MS or 100 mg DS in nursing recovery room,respectively.The major outcomes were assessed using post-drug-administration NRS score rated by subjects every 2 hours in the first 12 hours and every 4 hours in the second 12 hours.Side effects of women and their neonates as well as the patient and nurse satisfaction were recorded as secondary outcomes.Results Totally 49 subjects finished the trial.Pain scores were significantly different in the first 12 hour(7.32±1.67 vs.2.59±0.86,P=0.041),but not in the second 12-hour period.Few mild or moderate side effects were reported by the women subjects,which included nausea,urinary retention and others.No complications was found in neonates.The majority of patients and all nurses were satisfied with the drug administration.Conclusion Although MS and DS are both safe and satisfactory for post-cesarean pain management,MS decreases pain score more effectively than DS,at least during the first 12 hours after drug administration.
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