摘要
目的 :探讨瑞芬太尼联合右美托咪定治疗老年急腹症患者的镇痛效果以及安全性。方法 :选取2015年5月～2016年7月在我院接受治疗的老年急腹症患者88例,采用随机数表法将患者分为联合组(n=45)和单一组(n=43)。单一组给予右美托咪定治疗,联合组给予瑞芬太尼+右美托咪定治疗。对比患者各T1(麻醉前)、T2(插管后5min)、T3(手术结束时)等时间点MAP(平均动脉压)、HR(心率)、Sp O2(脉搏血氧饱和度)变化;比较患者治疗后苏醒时间、拔管时间、VAS评分;记录患者T4(拔管前15min)、T5(拔管)、T6(拔管后15min)时间点RSS(镇静评分)、RS(躁动评分)、OAAS(意识状态评分)评分变化;比较患者个时间点CRP(C反应蛋白)、IL-10(白细胞介素-10)、TNF-α(肿瘤坏死因子)变化,记录患者治疗后不良反应发生率。结果 :治疗后,两组患者T1、T2时间点HR、Sp O2对比,无差异;T3时联合组患者HR、Sp O2与单一组对比,差异具有统计学意义;治疗后,联合组苏醒时间、拔管时间(23.02±5.56min、2.89±0.58d)短于对照组(29.02±5.89min、3.45±0.55d);联合组患者VAS评分(3.89±0.78分)低于对照组(5.10±1.20分);两组患者各时间点RSS评分对比无统计学意义;T 4时患者RS以及OAAS评分对比,无统计学意义;T5、T6时两组患者RS评分、OAAS评分均逐渐提高,联合组高于单一组;T1时两组患者CRP、TNF-α、IL-10水平差异均无统计学意义;T2、T3、T4时联合组患者CRP、TNF-α水平均低于单一组;而IL-10表达水平则高于单一组,两组对比具有显著性差异;治疗后,患者均有出现心动过缓、恶心呕吐、呼吸抑制等不良反应,联合组总发生率8.89%低于对照组30.23%。结论 :给予老年急腹重症患者瑞芬太尼联合右美托咪定治疗,可降低患者CRP、TNF-α水平,提高IL-10水平,缓解患者麻醉苏醒期躁动,降低患者VAS评分,镇痛效果显著,且不良反应发生率低,效果显著。
Objective To investigate the analgesic effect and safety of remifentanil and dexmedetomidine in the treatment of elderly patients with acute abdomen. Methods 88 elderly patients with acute abdomen from May 2015 to July 2016 in our hospital were randomly were divided into combined group(n=45) and single group(n=43). A single group was treated with dexmedetomidine, and the combined group was treated with remifentanil plus right metoamidine. The comparison of T1 patients(before anesthesia(T2), 5 min after intubation(T3), at the end of surgery) at the time of MAP(mean arterial pressure), HR(heart rate), SpO2(Sp O2) changes were compared after treatment; recovery time, extubation time and VAS score were recorded; T4(Stubbs 15 min(T5), before extubation(T6), 15 min after extubation time(RSS), RS(score), OAAS(agitation score) consciousness scores) score change; compared with the time point CRP(C reactive protein), IL-10(interleukin-10), alpha TNF-(tumor necrosis factor) changes were recorded after treatment, the incidence of adverse reaction. Results After treatment, two groups of patients with T1, T2 HR, SpO2 time point comparison, no difference; T3 group of patients with HR, SpO2 and single group contrast, the difference was statistically significant; combination group after treatment, recovery time and extubation time(23.02+5.56 min, 2.89+0.58 d) shorter than the control group(29.02+5.89 min, 3.45+0.55 d); a group of patients with VAS score(3.89+0.78) is lower than that of the control group(5.10+1.20); the two groups of patients at each time point RSS score comparison was not statistically significant; 4 patients with RS and T the OAAS score comparison, no statistically significant; T5, T6 of the two groups of patients with RS score and OAAS score were gradually increased, the United Group was higher than that of single group; T1 two group were CRP, TNF-alpha, IL-10 level showed no significant difference; T 2, T3, T4, CRP group of patients with TNF-was higher than that of single alpha group; and the expression level
出处
《湖南师范大学学报（医学版）》
2018年第5期47-50,共4页
Journal of Hunan Normal University(Medical Sciences)
基金
重庆市自然科学基金项目(2015CFB185)
关键词
瑞芬太尼
右美托咪定
急腹症
镇痛效果
remifentanil
dexmedetomidine
acute abdomen
analgesic effect
