西藏藏族产妇剖宫产后硬膜外吗啡瘙痒反应的临床观察

Clinical Observation of Epidural Morphine Induced Pruritus in Tibetan Parturients after Cesarean Section

摘要:

目的 旨在基于西藏人群进行临床观察，研究西藏藏族产妇的硬膜外吗啡所致瘙痒（Epidural Morphine Induced Pruritus，EMIP）的临床特点。 方法 这是一项前瞻性单中心临床观察研究。选取西藏藏族剖宫产妇作为研究对象，在吗啡给药后3、6、12、24、48小时进行随访评估。首要结局指标是EMIP发病率。此外，还记录瘙痒的发生、持续时间和部位等其他信息。 结果 共有17名受试者入选，全部完成临床观察。其中2名产妇发生EMIP。EMIP患者主要症状为头面部、胸腹部瘙痒，其瘙痒症状分别出现于吗啡给药后16小时与2小时，瘙痒持续时间分别为24小时与3小时。 结论 本研究发现西藏藏族产妇EMIP发生率为11.8%，EMIP病例的瘙痒特点与文献报道大体一致。西藏藏族EMIP可能的危险因素有待积累更多数据进一步探讨。

Abstract:

Objective The purpose of this study is to find the clinical characteristics of epidural morphine-induced pruritus (EMIP) in Tibetan parturients based on the clinical observation Methods This is a prospective single-center clinical observational study. Follow-up evaluation was performed at 3, 6, 12, 24 and 48 hours after morphine administration. The primary outcome was the incidence of EMIP. In addition, the occurrence, duration and location of pruritus were recorded. Results A total of 17 subjects were selected and all completed the clinical observation. Two of them had EMIP. The main symptoms of EMIP patients were pruritus on the head, face, chest and abdomen. The pruritus symptoms emerged at 16 and 2 hours after morphine administration, lasting 24 and 3 hours, respectively. Conclusion This study found that the incidence of EMIP among parturients in Tibet was 11.8%. The clinical characteristics of EMIP were generally consistent with those reported in the literature. The possible risk factors of EMIP among Tibetan parturients need to be further explored by accumulating more data.