摘要
目的:探讨地佐辛联合舒芬太尼对开胸患者术后镇痛镇静效果、血流动力学及免疫功能的影响。方法:选取2017年1月~2018年12月期间新疆医科大学附属第一医院收治的拟行开胸手术患者70例,根据术后镇痛药物的不同将患者分为对照组(n=35)和研究组(n=35),对照组术后给予舒芬太尼镇痛,研究组术后给予地佐辛联合舒芬太尼镇痛。比较两组患者镇痛镇静效果、血流动力学、免疫功能及不良反应发生情况。结果:研究组术后6 h、12 h、24 h视觉疼痛模拟评分法(VAS)评分呈逐渐递减趋势,且低于对照组(P<0.05)。研究组术后3 h、6 h、12 h、24 h Ramsay镇静评分均低于对照组(P<0.05)。研究组术后5 min、3 h、12 h心率(HR)、舒张压(DBP)、收缩压(SBP)均低于对照组(P<0.05)。两组患者术后1 d、7 d CD3^+、CD4^+/CD8^+、自然杀伤(NK)细胞水平均呈先降低后升高趋势,术后7 d可恢复至术前水平(P<0.05),研究组术后1 d CD3^+、CD4^+/CD8^+、NK细胞水平高于对照组(P<0.05)。研究组不良反应发生率低于对照组(P<0.05)。结论:开胸患者术后应用地佐辛联合舒芬太尼,镇静镇痛效果较好,可有效维持患者血流动力学稳定,减轻机体免疫功能抑制,安全可靠。
Objective:To investigate the effects of dezocine combined with sufentanil on analgesia,sedation,hemodynamics and immune function after thoracotomy.Methods:70 patients undergoing thoracotomy were selected from the First Affiliated Hospital of Xinjiang Medical University from January 2017 to December 2018.They were divided into control group(n=35)and study group(n=35)according to different analgesics after operation.The control group was given sufentanil analgesia after operation,and the study group was given dezocine combined with sufentanil analgesia after operation.The effects of analgesia and sedation,hemodynamics,immune function and adverse reactions were compared between the two groups.Results:Visual analogue pain score(VAS)in the study group decreased gradually at 6 h,12 h and 24 h after operation,and was lower than that in the control group(P<0.05).Ramsay sedation scores in the study group were lower than those in the control group at 3 h,6 h,12 h and 24 h after operation(P<0.05).The heart rate(HR),diastolic blood pressure(DBP)and systolic blood pressure(SBP)of the study group were lower than those of the control group at 5 min,3 h,12 h and 24 h after operation(P<0.05).The levels of CD3^+,CD4^+/CD8^+,natural killing(NK)cells in the two groups decreased first and then increased at 1 d and 7 d after operation,and recovered to the preoperative level at 7 d after operation(P<0.05).The levels of CD3^+,CD4^+/CD8^+,NK cells in the study group were higher than those in the control group at 1 d after operation(P<0.05).The incidence of adverse reactions in the study group was lower than that in the control group(P<0.05).Conclusion:Dezocine combined with sufentanil is effective in sedation and analgesia after thoracotomy.It can effectively maintain the hemodynamic stability of patients,alleviate the suppression of immune function,and it is safe and reliable.
作者
范甜
李珊珊
李艾芳
秦文沛
王江
FAN Tian;LI Shan-shan;LI Ai-fang;QIN Wen-pei;WANG Jiang(Department of Anesthesiology,The First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang,830054,China)
出处
《现代生物医学进展》
CAS
2020年第3期519-523,共5页
Progress in Modern Biomedicine
基金
新疆维吾尔自治区自然科学基金项目(2016211B164)。
