目的 探讨布托啡诺在瘢痕子宫剖宫产术中腹膜牵拉反应中的预防价值。方法 选择2017年5月—2018年5月治疗的瘢痕子宫剖宫产术患者80例作为对象,随机数字表分为观察组、对照组(各40例),观察组胎儿娩出后立即应用布托啡诺,对照组不采用静脉辅助药物。统计并记录两组平均血流动力学水平;采用直观模拟量表(VAS)对两组缝合子宫时(T₁),用纱布清理腹腔时(T₂),缝合腹膜时(T₃),手术结束按压子宫时(T₄)疼痛情况进行评估;统计并记录两组术中牵拉反应发生率、药物不良反应情况。结果 观察组HR、MSP、SPO₂均显著低于对照组,两组对比差异有统计学意义(P<0.05);观察组各时间点VAS评分明显较对照组更低,两组比较差异有统计学意义(P<0.05);观察组牵拉反应发生率为10%,对照组为55%,观察组明显较对照组更低,差异有统计学意义(P<0.05);观察组不良反应发生率为2.5%,对照组未见药物不良反应,两组对比差异无统计学意义(P>0.05)。结论 采用布托啡诺能够稳定瘢痕子宫产妇剖宫产血流动力学水平,减轻产妇疼痛,改善牵拉反应,且用药较为安全。

Objective To explore the preventive value of butorphanol in peritoneal traction reaction during cesarean section of scarred uterus.Methods Eighty cases of cesarean section of scar uterus treated from May 2017 to May 2018 were selected as study subjects, and divided into observation group and control group with 40 cases in each group by random number table.The observation group was given butorphanol immediately after delivery, while the control group was not given intravenous adjuvant drugs.The average hemodynamics of the two groups were recorded; pain was evaluated by Visual Analogue Scale (VAS) during uterine suture (T₁), abdominal cavity cleaning (T₂), peritoneal suture (T₃), and uterine compression (T₄); the incidence rate of traction reaction and adverse drug reactions of the two groups were also recorded.Results The HR, MSP, and SPO₂ in the observation group were significantly lower than those in the control group (P<0.05); the VAS score in the observation group was significantly lower than that in the control group at each time point (P<0.05); the incidence rate of traction reaction in the observation group (10%) was also significantly lower than that in the control group (55%) (P<0.05).The incidence rate of adverse reactions was 2.5% in the observation group, and there was no adverse drug reactions in the control group, with no significant difference between the two groups (P>0.05).Conclusion Butorphanol can stabilize the hemodynamics of cesarean section of scarred uterus, alleviate maternal pain, and improve traction reaction; it is safe to use butorphanol.