蚌埠医学院学报
蚌埠醫學院學報
방부의학원학보
ACTA ACADEMIAE MEDICINAE BENGBU
2014年
9期
1176-1179
,共4页
宫颈癌根治手术%舒芬太尼%右美托咪定%术后镇痛
宮頸癌根治手術%舒芬太尼%右美託咪定%術後鎮痛
궁경암근치수술%서분태니%우미탁미정%술후진통
cervical cancer radical surgery%sufentanil%dexmedetomidine%postoperative analgesia
目的：观察舒芬太尼复合右美托咪啶在宫颈癌根治术术后镇痛的效果。方法：选取ASAⅠ~Ⅱ级的择期宫颈癌根治术患者56例,随机分为观察组和对照组,对照组术后镇痛给予舒芬太尼1.0μg·kg-1·d-1,观察组术后镇痛给予舒芬太尼1.0μg·kg-1·d-1+右美托咪定1.0μg·kg-1·d-1,2组术后镇痛持续量2 ml/h,单次负荷剂量2 ml,锁定时间15 min,总容量100 ml。采用疼痛视觉模拟( VAS)评分评价2组手术结束时( T1)及术后2 h( T2)、8 h( T3)、24 h( T4)与48 h( T5)疼痛程度和镇静评分标准( Ramsay)分级；记录导尿管不适、呕吐、恶心发生率和患者满意度。结果：2组术后各时点疼痛VAS评分均<4分,T2~T5时点观察组疼痛VAS评分显著低于对照组(P<0.01)；T2~T5时点观察组Ramsay分级均明显低于对照组(P<0.01)；观察组导尿管不适、恶心、呕吐发生率均低于对照组(P<0.05)；观察组患者满意度高于对照组(P<0.05)。结论：舒芬太尼复合右美托咪啶适合在宫颈癌根治术后镇痛中使用,与单纯舒芬太尼相比较,术后镇痛效果更好,不良反应发生率更低,患者更为舒适。
目的：觀察舒芬太尼複閤右美託咪啶在宮頸癌根治術術後鎮痛的效果。方法：選取ASAⅠ~Ⅱ級的擇期宮頸癌根治術患者56例,隨機分為觀察組和對照組,對照組術後鎮痛給予舒芬太尼1.0μg·kg-1·d-1,觀察組術後鎮痛給予舒芬太尼1.0μg·kg-1·d-1+右美託咪定1.0μg·kg-1·d-1,2組術後鎮痛持續量2 ml/h,單次負荷劑量2 ml,鎖定時間15 min,總容量100 ml。採用疼痛視覺模擬( VAS)評分評價2組手術結束時( T1)及術後2 h( T2)、8 h( T3)、24 h( T4)與48 h( T5)疼痛程度和鎮靜評分標準( Ramsay)分級；記錄導尿管不適、嘔吐、噁心髮生率和患者滿意度。結果：2組術後各時點疼痛VAS評分均<4分,T2~T5時點觀察組疼痛VAS評分顯著低于對照組(P<0.01)；T2~T5時點觀察組Ramsay分級均明顯低于對照組(P<0.01)；觀察組導尿管不適、噁心、嘔吐髮生率均低于對照組(P<0.05)；觀察組患者滿意度高于對照組(P<0.05)。結論：舒芬太尼複閤右美託咪啶適閤在宮頸癌根治術後鎮痛中使用,與單純舒芬太尼相比較,術後鎮痛效果更好,不良反應髮生率更低,患者更為舒適。
목적：관찰서분태니복합우미탁미정재궁경암근치술술후진통적효과。방법：선취ASAⅠ~Ⅱ급적택기궁경암근치술환자56례,수궤분위관찰조화대조조,대조조술후진통급여서분태니1.0μg·kg-1·d-1,관찰조술후진통급여서분태니1.0μg·kg-1·d-1+우미탁미정1.0μg·kg-1·d-1,2조술후진통지속량2 ml/h,단차부하제량2 ml,쇄정시간15 min,총용량100 ml。채용동통시각모의( VAS)평분평개2조수술결속시( T1)급술후2 h( T2)、8 h( T3)、24 h( T4)여48 h( T5)동통정도화진정평분표준( Ramsay)분급；기록도뇨관불괄、구토、악심발생솔화환자만의도。결과：2조술후각시점동통VAS평분균<4분,T2~T5시점관찰조동통VAS평분현저저우대조조(P<0.01)；T2~T5시점관찰조Ramsay분급균명현저우대조조(P<0.01)；관찰조도뇨관불괄、악심、구토발생솔균저우대조조(P<0.05)；관찰조환자만의도고우대조조(P<0.05)。결론：서분태니복합우미탁미정괄합재궁경암근치술후진통중사용,여단순서분태니상비교,술후진통효과경호,불량반응발생솔경저,환자경위서괄。
Objective:To observe the effects of sufentanil combined with dexmedetomidine on postoperative analgesia in cervical cancer patients with radical hysterectomy. Methods:Fifty-six ASAⅠor Ⅱcervical cancer patients scheduled by radical hysterectomy were randomly divided into the observation group and control group(28 cases each group). At postoperative analgesia,the control group were treated with sufentanil for 1. 0 μg · kg-1 · d-1 , the observation group were treated with sufentanil for 1. 0 μg · kg-1 · d-1 combined with dexmedetomidine for 1.0 μg·kg-1·d-1,the postoperative analgesia continuous perfusion amount for 2 ml/h,single bolus for 2 ml,lockout time for 15 min and total volume for 100 ml were implemented in two groups. The degree of pain and sedation grade in two groups were evaluated using visual analog scale(VAS) after operation(T1) and at 2(T2),8(T3),24(T4) and 48 hours ( T5 ) after operation. The incidences of bladder discomfort,nausea and vomiting,and satisfaction of patients in two groups were recorded after operation. Results:The postoperative VAS scores in two groups in all time points were less than 4. The pain scores of the observation group at T2 to T5 were significantly lower than that of the control group(P<0. 01). The Ramesay grades of the observation group at T2 to T5 were significantly lower than that of the control group(P<0. 01). The incidences of bladder discomfort,nausea and vomiting in observation group were lower than those in control group(P<0. 05),the satisfaction of patient in observation group were higher than that in control group ( P < 0. 05 ). Conclusions:The postoperative analgesia effects of sufentanil combined with dexmedetomidine on radical hysterectomy are better than that of sufentanil,which is lower adverse reaction and more comfortable.
