右美托咪定联合氟比洛芬酯对甲状腺术后患者疼痛和认知功能的影响  

Effect of dexmedetomidine combined with flurbiprofen axetil on postoperative pain and cognitive function of patients after thyroid gland surgery

作　　者：张志宇[1] 武志鹏[2] 孙杉杉 任娟[2] Zhang Zhiyu;Wu Zhipeng;Sun Shanshan;Ren Juan(Department of Traumatology,the People's Hosptial of Shouguang,Shouguang,Shandong 262700,China;Department of Anesthesiology,the People's Hosptial of Shouguang,Shouguang,Shandong 262700,China)

机构地区：[1]寿光市人民医院创伤外科,山东省262700 [2]寿光市人民医院麻醉科,山东省262700

出　　处：《中国基层医药》2020年第3期267-270,共4页Chinese Journal of Primary Medicine and Pharmacy

基　　金：山东省潍坊市卫生和计划生育委员会科研项目(2017wsjs030)。

摘　　要：目的探讨右美托咪定联合氟比洛芬酯对甲状腺手术后患者疼痛和认知功能的影响。方法选择寿光市人民医院2016年1月至2017年12月行甲状腺手术患者80例,采用随机数字表法分为C、D、F、DF四组,每组20例。手术结束前30 min,C组注射0.9%氯化钠注射液,D组注射右美托咪定,F组注射氟比洛芬酯,DF组注射右美托咪定联合氟比洛芬酯。观察四组患者拔管时间和苏醒时间,术后应用视觉模拟评分量表(VAS)评分进行镇痛效果的评价,应用Riker镇静躁动评分行术后焦虑状况评定。结果C、D、F、FD组拔管时间分别为(16.66±3.37)min、(24.63±2.80)min、(14.55±3.74)min、(26.22±3.45)min,D组、DF组的拔管时间明显长于C组、F组(F=4.59,P<0.01)。D组苏醒时间[(17.98±2.54)min]、DF组苏醒时间[(17.84±3.63)min]均明显长于F组[(10.92±2.21)min]、C组[(9.95±2.16)min](F=5.01,P<0.01)。DF组苏醒后30 min、3 h、6 h和24 h的VAS评分明显低于F组和D组(F=4.53、4.59、4.61、4.35,均P<0.01)。C、D、F、FD组的Riker镇静评分分别为(5.28±1.81)分、(4.20±1.56)分、(4.24±2.01)分、(3.76±1.43)分,DF组的Riker镇静评分显著低于其他三组(F=3.01,P<0.01)。DF组手术后3 h、1 d和3 d认知功能简易智能量表(MMSE)评分均显著高于C组(F=4.95、4.45、4.51,均P<0.01)。结论联合使用右美托咪定和氟比洛芬酯可显著降低甲状腺手术后疼痛,缓解术后认知功能障碍。Objective To investigate the effect of dexmedetomidine combined with flurbiprofen axetil on pain and cognitive function of patients after thyroidectomy.Methods A total of 80 patients with thyroid gland surgery in the People's Hosptial of Shouguang from January 2016 to December 2017 were selected and randomly divided into four groups according to the digital table:saline control group(C),dexmedetomidine group(D),flurbiprofen axetil group(F),dexmedetomidine combined with flurbiprofen axetil group(DF),with 20 casess in each group.The extubation time and wake-up time of the four groups were observed.The VAS scores were used to assess the analgesic effect after surgery,and the Riker sedation scale was used to assess postoperative anxiety.Results The extubation time of the C,D,F and FD group were(16.66±3.37)min,(24.63±2.80)min,(14.55±3.74)min,(26.22±3.45)min,respectively,which of group D and group DF was significantly longer than that in group C and group F(F=4.59,P<0.01).The recovery time of group D[(17.98±2.54)min]and group DF[(17.84±3.63)min]was significantly longer than that of group F[(10.92±2.21)min]and group C[(9.95±2.16)min](F=5.01,P<0.01).The VAS scores of group DF at 30 min,3 h,6 h and 24 h after recovery were significantly lower than those of group F and group D(F=4.53,4.59,4.61,4.35,all P<0.01).The Rick sedation scores of C,D,F and FD groups were(5.28±1.81)points,(4.20±1.56)points,(4.24±2.01)points and(3.76±1.43)points,respetively,which of group DF was significantly lower than those of the other three groups(F=3.01,P<0.01).The MMSE scores of cognitive function in group DF at 3 h,1 d and 3 d after surgery were significantly higher than those in group C(F=5.89,4.95,4.56,all P<0.01).Conclusion The combined use of dexmedetomidine and flurbiprofen axetil significantly reduces pain and relieves postoperative cognitive impairment after thyroid surgery.

关 键 词：麻醉和镇痛 右美托咪定 氟比洛芬酯 甲状腺 外科手术 疼痛 手术后 认知 临床对照试验 

分 类 号：R614[医药卫生—麻醉学]