全麻下腹部手术患者的围术期睡眠质量对术后恢复的影响  

Perioperative sleep quality in patients with general anesthesia and postoperative recovery in patients with abdominal surgery

作　　者：陈燕[1] 颜莉丽[1] 邱江江 王俊鹏 CHEN Yan;YAN Lili;QIU Jiangjiang(Department of Anesthesiology,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450002,China)

机构地区：[1]郑州大学第二附属医院麻醉科,郑州450002

出　　处：《国际精神病学杂志》2021年第1期156-158,179,共4页Journal Of International Psychiatry

摘　　要：目的探讨全麻患者围手术期睡眠质量对腹部手术患者术后胃肠功能恢复、疼痛程度及麻醉药物用量的影响。方法纳入2018年2月~2019年10月在XX医院胃肠外科行全麻手术的胃肠道疾病患者100例,术前1天采用匹兹堡睡眠质量指数量表对患者近1月睡眠状况进行评估,分为睡眠障碍组和对照组,比较两组患者围手术期麻醉药品丙泊酚、瑞芬太尼用量、记录两组患者术后胃肠道功能恢复情况、采用疼痛视觉模拟评分量表(VAS)对患者术后疼痛状况进行评分,于出院时采用多维疲乏量表对患者围手术期疲劳程度进行评分。结果睡眠障碍组围手术期丙泊酚用量高于对照组(P<0.05);(2)睡眠障碍组术后首次排气时间、肠鸣音恢复时间、首次排便时间高于对照组(P<0.05);(3)术后12h、24h、48h、72h两组VAS评分均呈下降趋势(F趋势=34.991,15.799,P<0.05);睡眠障碍组术后12h、24h、48h、72h VAS评分高于对照组(P<0.05);(4)MFI-20评分显示,睡眠障碍组心理疲劳、躯体疲劳、精神疲劳及平均疲劳程度评分高于对照组(P<0.05);结论伴有睡眠障碍的腹部手术患者其围手术期丙泊酚用量更大、术后疼痛感更强,更易感觉疲劳,术后胃肠道功能恢复更慢。Objective To investigate the influence of perioperative sleep quality of general anesthesia patients on gastrointestinal function recovery,pain degree and anesthetic drug consumption in patients undergoing abdominal surgery.Methods From February 2018 to October 2019,100 patients with gastrointestinal diseases undergoing general anesthesia in gastrointestinal surgery of XX Hospital were included.The Pittsburgh Sleep Quality Index Scale was used to evaluate the patients'sleep status in the past month,all the patients were divided into a sleep disorder group and a control group.The perioperative use of propofol and remifentanil,the postoperative gastrointestinal function recovery,the the postoperative pain status,and the patients'perioperative fatigue during discharge were compared between two groups.Results According to the preoperative PSQI score,36 out of 100 patients had sleep disorders(.1)The amount of propofol used in the sleep disorder group during the perioperative period was higher than that of the control group(P<0.05).(2)The time of first exhaustion,recovery time of bowel sounds,and time of first bowel movement after sleep disorder group were higher than those of control group(P<0.05).(3)The VAS scores in both of two groups at 12h,24h,48h and 72h postoperatively showed a downward trend(F trend=34.991,15.799,P<0.05).The VAS scores of the sleep disorder group after 12h,24h,48h and 72h were higher than those of the control group(P<0.05).(4)The MFI-20 score showed that the mental fatigue,physical fatigue,mental fatigue and average fatigue degree scores of the sleep disorder group were higher than the control group(P<0.05).Conclusion Sleep disturbance will increase the amount of propofol used during abdominal surgery,and the postoperative pain will be more severe.Patients will be more prone to fatigue,and the recovery of gastrointestinal function after surgery will be slower.

关 键 词：睡眠障碍 腹部手术 麻醉用量 疼痛 

分 类 号：R749.99[医药卫生—神经病学与精神病学]