摘要
目的分析右美托咪定复合舒芬太尼在产科患者术后镇痛镇静中的效果及对免疫功能的影响。方法选取2022年1月1日-2023年5月31日我院妇产科行择期剖宫产手术的64例产妇为研究对象,采用随机数字表法分为对照组(n=32)和观察组(n=32)。对照组术后给予枸橼酸舒芬太尼自控镇痛,观察组术后给予右美托咪定复合枸椽酸舒芬太尼自控镇痛,比较两组产妇术后不同时间(6、12、24、48 h)疼痛(VAS)评分、Ramsay镇静评分、免疫功能指标(CD4^(+)、CD8^(+)、NK细胞活性)、24 h出血量、24 h内血流动力学指标[心率(HR)、平均动脉压(MAP)]、不良反应发生率。结果观察组术后6、12、24、48 h的VAS评分均小于对照组(P<0.05);观察组术后6、12、24、48 h的Ramsay评分均高于对照组(P<0.05);两组术后2 h的CD4^(+)、CD8^(+)、NK均低于术前,但观察组高于对照组(P<0.05);观察组24 h出血量少于对照组(P<0.05);两组术后2 h的HR、MAP均低于术前,且观察组低于对照组(P<0.05);观察组不良反应发生率为9.38%,低于对照组的21.88%(P<0.05)。结论右美托咪定复合舒芬太尼可提升产科患者术后镇痛、镇静效果,减少产后出血量,增强免疫功能,减小产后血流动力学影响,且不良反应发生率小,具有重要的临床应用价值。
Objective To analyze the effect of dexmedetomidine combined with sufentanil on postoperative analgesia and sedation in obstetric patients and its effect on immune function.Methods A total of 64 parturients who underwent elective cesarean section in obstetrics and gynecology department of our hospital from January 1,2022 to May 31,2023 were selected as the research objects.They were divided into control group(n=32)and observation group(n=32)by random number table method.The control group was given sufentanil citrate self-controlled analgesia after operation,and the observation group was given dexmedetomidine combined with sufentanil citrate self-controlled analgesia after operation.The pain(VAS)score,Ramsay sedation score,immune function index(CD4^(+),CD8^(+),NK cell activity),24 h bleeding volume,24 h hemodynamic index[heart rate(HR),mean arterial pressure(MAP)]and incidence of adverse reactions were compared between the two groups at different time(6,12,24,48 h)after operation.Results The VAS score of the observation group at 6,12,24 and 48 h after operation was lower than that of the control group(P<0.05).The Ramsay score of the observation group at 6,12,24 and 48 h after operation was higher than that of the control group(P<0.05).The levels of CD4^(+),CD8^(+)and NK in the two groups at 2 h after operation were lower than those before operation,but those in the observation group were higher than those in the control group(P<0.05).The amount of bleeding in the observation group was less than that in the control group at 24 h(P<0.05).The HR and MAP of the two groups at 2 h after operation were lower than those before operation,and those of the observation group were lower than those of the control group(P<0.05).The incidence of adverse reactions in the observation group was 9.38%,which was lower than 21.88%in the control group(P<0.05).Conclusion Dexmedetomidine combined with sufentanil can improve postoperative analgesia and sedation in obstetric patients,reduce postpartum hemorrhage,enhance immune function,reduce postpartum hemodynamic effects,and the incidence of adverse reactions is small,which has important clinical application value.
作者
彭辉辉
PENG Huihui(Anesthesiology Department of Nancheng County People's Hospital,Nancheng 344799,Jiangxi,China)
出处
《医学信息》
2024年第20期135-138,共4页
Journal of Medical Information
基金
抚州市科技计划项目(编号:202310013483)。
关键词
右美托咪定
舒芬太尼
产科
镇痛镇静
免疫功能
Dexmedetomidine
Sufentanil
Obstetric
Analgesia and sedation
Immune function
