摘要
目的探讨右美托咪定联合地佐辛对急性肠梗阻患者术后痛觉过敏及胃肠功能恢复的影响。方法选取2021年1月-2022年1月在江油市第二人民医院实施手术治疗的86例急性肠梗阻患者,随机将全部的患者分为两组,即右美托咪定联合地佐辛组(观察组)及单纯右美托咪定组(对照组),各43例,记录两组苏醒时间、气管导管拔除时间,记录两组患者术后不同的时间点视觉模拟评分法(visual analogue scale,VAS)改变情况。记录术后住院过程中出现各种并发症的概率情况。于右美托咪定负荷剂量输注前(T0)、术后1 d(T1)、术后3 d(T2)和术后7 d(T3)时采用酶联免疫吸附测定法检测血清二胺氧化酶(diamine oxidase,DAO)、D-乳酸(D-lactic acid,D-LAC)、细菌内毒素(Bacillusthuringiensis,BT)的浓度水平。结果两组苏醒时长、气管导管的拔除时长比较并无统计学方面的差异(P>0.05);观察组术后1、2、6、12、24 h的VAS评分均较对照组患者低(P<0.05);观察组术后住院期间并发症发生率11.63%低于对照组44.19%(P<0.05);两组T1、T2、T3的血清DAO、D-LAC、BT水平均低于T0;T2、T3均低于T1;T3均低于T2(P<0.05),观察组的血清DAO、D-LAC、BT水平均较对照组患者低(P<0.05)。结论复合麻醉中利用右美托咪定能够对肠梗阻手术患者瑞芬太尼麻醉后的痛觉过敏产生抑制作用,提升患者的麻醉质量,并一定程度上改善手术的预后,并发症发生率较低,安全性高,可保护患者肠道屏障方面的功能,有助于肠道功能恢复。
Objective To explore the effect of dexmedetomidine combined with diazosin on postoperative hyperalgesia and gastrointestinal function recovery in patients with acute intestinal obstruction.Methods We selected 86 patients with acute intestinal obstruction who underwent surgical treatment in our hospital from January 2021 to January 2022,and they were randomly divided into two groups including dextromethyl combined with diazosin group and dextromethyl alone group,with 43 patients in each.The time of awakening and tracheal catheter removal,and the changes of visual analog scale(VAS)at different time points after operation in the two groups were recorded.The probability of various complications in the course of hospitalization after operation was recorded.The concentrations of serum diamine oxidase(DAO),D-lactic acid(D-LAC),and bacterial endotoxin(BT)were measured by enzyme-linked immunosorbent assay before infusion of dexamethasone at a fixed dose(T0),and 1 day(T1),3 days(T2),7 days after operation(T3).Results There were no differences in the recovery time and tracheal catheter removal time between the two groups(P>0.05).VAS scores at 1,2,6,12,and 24h after operation in the dexmede combined with Dizocine group were lower than those in the Dexmede alone group(P<0.05).The incidence of complications during postoperative hospitalization was 11.63%in the dexmede combined group,which was lower than that in the dexmede alone group with it of 44.19%(P<0.05)..The levels of DAO,D-LAC,and BT in serum at T1,T2,and T3 in the two groups were lower than those at T0(P<0.05),and they were lower in the dexmede combined group compared to the Dexmede alone group(P<0.05),T2 and T3 are lower than T1;T3 is lower than T2(P<0.05).Conclusion In combination anesthesia,dexmedetomidine can inhibit pain sensitivity in patients undergoing intestinal obstruction surgery after remifentanil anesthesia,and improve the quality of anesthesia for patients and the prognosis of surgery.The incidence of complications is low,the safety is high,and the function of the intestinal barrier of patients can be protected,which is conducive to the recovery of intestinal function.
作者
沈学庆
于桂龙
赵燕
SHEN Xueqing;YU Guilong;ZHAO Yan(Department of Anesthesiology,Jiangyou Second People's Hospital,Jiangyou,Sichuan,621700)
出处
《转化医学杂志》
2023年第1期44-47,63,共5页
Translational Medicine Journal
关键词
急性肠梗阻
右美托咪定
地佐辛
术后痛觉过敏
胃肠功能
Acute intestinal obstruction
Dexmedetomidine
Dizocine
Postoperative hyperalgesia
Gastrointestinal function
