摘要
目的探究右美托咪定(dexmedetomidine,Dex)预防经尿道前列腺切除术(transurethral resection of prostate,TURP)患者术后谵妄(postoperative delirium,POD)及术后躁动(postoperative agitation,PA)的效果,并分析其对生殖激素的影响。方法行TURP的患者168,按随机数字表法分为对照组和观察组(每组84例)。对照组术后给予常规舒芬太尼、丙泊酚患者自控静脉镇痛治疗,观察组在对照组基础上联合应用Dex进行患者自控静脉镇痛治疗。记录患者术后2、8、12、24 h VAS评分与Ramsay镇静评分,记录患者术后1、2、3 d POD的发生率,ELISA法检测患者术后24 h及术后1周血清生殖激素水平,记录患者术后2、8、12、24 h MAP与心率,观察术后1周内患者不良反应发生情况。结果与对照组比较,观察组术后2 h Ramsay镇静评分,术后8、12、24 h VAS评分和Ramsay镇静评分降低(P<0.05)。观察组患者手术当日,术后1、2 d POD发生率及术后3 d内POD总发生率低于对照组(P<0.05)。术后24 h,观察组患者血清睾酮(testosterone,T)和雌激素(estrogenic hormone,E2)水平高于对照组(P<0.05),而卵泡刺激素(follicle stimulating hormone,FSH)和黄体生成素(luteotropic hormone,LH)的水平与对照组比较,差异无统计学意义(P>0.05)。术后1周,两组患者血清生殖激素水平较术后24 h均升高(P<0.05)。两组患者术后各时点MAP和心率差异无统计学意义(P>0.05)。对照组患者术后仅出现1例恶心呕吐,观察组无不良反应发生。结论TURP患者术后采用Dex镇痛效果显著,可有效降低POD与PA的发生率,从而间接促进性腺功能尽快恢复,帮助患者早日康复。
Objective To explore the effect of dexmedetomidine(Dex)on postoperative delirium(POD)and postoperative agitation(PA)after transurethral resection of the prostate(TURP),and to analyze its effect on reproductive hormones.Methods One hundred and sixty-eight cases of male patients undergoing TURP were selected,and divided into the control group and observation group(n=84)according to the random number table method.The control group was given conventional intravenous sufentanil and propofol patient-controlled analgesia,and the observation group was combined with Dex for intravenous patient-controlled analgesia on the basis of the control group.Visual Analogue Scale(VAS)scores and Ramsay sedation scores were recorded at 2,8,12 h and 24 h after surgery.The incidence of POD on day 1,2 and 3 were also recorded.Serum reproductive hormone levels were measured by enzyme-linked immunosorbent assay(ELISA)at 24 h and 1 week after surgery.Mean artery pressure(MAP)and heart rate were recorded at 2,8,12 h and 24 h after surgery,and adverse reactions were observed within 1 week after surgery.Results The Ramsay scores of the observation group were significantly lower than that of the control group at 2 h after surgery,and VAS score and Ramsay scores at 8,12 h and 24 h were significantly lower than those in the control group(P<0.05).The total incidence of POD within 3 d after surgery in the observation group(3.57%)was significantly lower than that in the control group(11.90%)(P<0.05).At 24 h after surgery,serum testosterone(T)and estrogenic hormone(E2)levels in the observation group were significantly higher than those in the control group(P<0.05),while the levels of follicle stimulating hormone(FSH)and luteotropic hormone(LH)were not significantly different from those in the control group(P>0.05).One week after surgery,the serum reproductive hormone levels of the two groups were significantly higher than that at 24 h after surgery(P<0.05).There was no significant difference in map and heart rate between the two groups(P>0.05).There
作者
任广民
张纵横
Ren Guangmin;Zhang Zongheng(Department of Anesthesiology,Affiliated Hospital of Jining Medical College,Jining 272000,China;Department of Anesthesiology,the Second People's Hospital of Qingdao West Coast New Area,Qingdao 266400,China)
出处
《国际麻醉学与复苏杂志》
CAS
2020年第8期759-762,共4页
International Journal of Anesthesiology and Resuscitation
基金
山东省济宁市市级课题(2018SMNS004)。
关键词
右美托咪定
经尿道前列腺切除术
术后谵妄
术后躁动
生殖激素
Dexmedetomidine
Transurethral resection of the prostate
Postoperative delirium
Postoperative agitation
Reproductive hormones
