老年脊柱手术患者接受右美托咪定联合舒芬太尼自控静脉镇痛的神经功能评估  

Assessment of neurological function of patient-controlled intravenous analgesia in elderly spinal surgery patients who received dexmedetomidine combined with sufentanil

作　　者：刘欣[1] 夏乐强[1] 

机构地区：[1]四川省德阳市人民医院麻醉科,四川德阳618000

出　　处：《海南医学院学报》2016年第17期2049-2052,共4页Journal of Hainan Medical University

基　　金：德阳市科技局(2014SZ034)~~

摘　　要：目的:评估老年脊柱手术患者接受右美托咪定联合舒芬太尼自控静脉镇痛的神经功能保护作用。方法:选择130例在本院接受脊柱手术治疗的老年患者作为研究对象,随机分为接受观察组及对照组。观察组接受术后右美托咪定(1.5μg/kg)联合舒芬太尼(1μg/kg)自控静脉镇痛,对照组接受单纯舒芬太尼(3μg/kg)自控静脉镇痛。对比两组在术后镇痛不同时间点的神经内分泌、自主神经功能及细胞免疫功能等差异。结果:观察组接受术后自控静脉镇痛后,循环中的GIU、ACTH、Cor、Ins等神经内分泌因子水平,LF、HF、LF/HF等心率变异性指标值低于对应时间点的对照组(P<0.05);循环中CD3^+、CD4^+、CD4^+/CD8^+、NK细胞等细胞免疫指标值高于相应时间点的对照组(P<0.05)。结论:右美托咪定联合舒芬太尼是老年脊柱手术患者术后自控镇痛的良好方式,其中右美托咪定可以稳定自主神经系统及神经内分泌功能并减小手术对细胞免疫功能的影响,具有积极的临床意义。[ABSTRACT]Objective：To evaluate the neurological protective effects of patient-controlled intravenous analgesia in elder-ly spinal surgery patients who received dexmedetomidine combined with sufentanil.Methods：A total of 130 cases of elderly pa-tients who received spinal surgery in our hospital were selected as the research subjects and randomly divided into observation group and control group.Observation group received postoperative dexmedetomidine （1.5 μg/kg）combined with sufentanil （1μg/kg）for patient-controlled intravenous analgesia,and control group received sufentanil （3 μg/kg）alone for patient-con-trolled intravenous analgesia.Differences in postoperative neuroendocrine,autonomic nervous function,cellular immune func-tion,etc.were compared between two groups at different analgesia points in time.Results：Neuroendocrine factors such as GIU,ACTH,Cor and Ins levels in circulation,and heart rate variability indexes such as LF,HF and LF/HF values of obser-vation group after postoperative patient-controlled intravenous analgesia were lower than those of control group at correspond-ing points in time （P 〈0.05）;cellular immunity indexes such as CD3 ＋ ,CD4 ＋ ,CD4 ＋/CD8 ＋ and NK cell values in circulation were higher than those of control group at corresponding points in time （P 〈0.05 ）.Conclusion：Dexmedetomidine combined with sufentanil is a good way of postoperative patient-controlled intravenous analgesia for elderly spinal surgery patients, dexmedetomidine can stabilize autonomic nervous system and neuroendocrine function and reduce the effect of surgery on cellu-lar immune function,and it has positive clinical significance.

关 键 词：老年脊柱手术 右美托咪定 自控静脉镇痛 

分 类 号：R687.3[医药卫生—骨科学]