机构地区:[1]亳州市人民医院麻醉科,安徽亳州236800 [2]新乡市中心医院骨科,河南新乡453099
出 处:《新乡医学院学报》2022年第5期474-480,共7页Journal of Xinxiang Medical University
摘 要:目的探讨右美托咪定对行甲状腺癌根治术患者术后睡眠质量以及血清中食欲素A水平的影响。方法选择2020年1月至2021年6月在亳州市人民医院行全身麻醉下甲状腺癌根治术患者76例为研究对象,按照随机数字表法将患者分为观察组和对照组,每组38例。观察组患者在麻醉诱导前10 min静脉泵注右美托咪定0.5μg·kg^(-1)(生理盐水稀释至20 mL),术中以0.5μg·kg^(-1)·h^(-1)(速率为5 mL·h^(-1))维持至手术结束;对照组患者麻醉诱导前10 min泵入生理盐水20 mL,术中以5 mL·h^(-1)持续泵注生理盐水至手术结束。分别于术前1 d和术后1、3、5 d,应用匹兹堡睡眠质量指数量表(PSQI)评估患者主观睡眠情况,计算睡眠障碍发生率;应用酶联免疫吸附试验法检测血清中食欲素A水平,40项恢复质量评定量表(QoR-40)评估患者术后恢复质量。比较2组患者术后12 h内睡眠总时间、苏醒时间、复苏室停留时间、麻醉药用量及术后不良反应发生情况。结果术前1 d和术后5 d时,2组患者PSQI评分比较差异无统计学意义(P>0.05);术后1、3 d时,观察组患者PSQI评分显著低于对照组(P<0.01)。2组患者术后1、3、5 d时的PSQI评分显著高于术前1 d,术后3、5 d时PSQI评分显著低于术后1 d,术后5 d时PSQI评分显著低于术后3 d(P<0.01)。术后1、3 d时,观察组患者睡眠障碍发生率显著低于对照组(P<0.05);术后5 d时,观察组与对照组患者睡眠障碍发生率比较差异无统计学意义(P>0.05)。观察组患者术后1、3、5 d时睡眠障碍发生率比较差异无统计学意义(P>0.05)。对照组患者术后1 d与术后3 d时睡眠障碍发生率比较差异无统计学意义(P>0.05);对照组患者术后5 d时睡眠障碍发生率显著低于术后1、3 d(P<0.05)。术前1 d、术后5 d时,2组患者血清中食欲素A水平比较差异无统计学意义(P>0.05);术后1、3 d时,观察组患者血清中食欲素A水平显著低于对照组(P<0.01)。对照组患者�Objective To investigate the effects of dexmedetomidine on postoperative sleep quality and srum orexin A level in patients underwent radical thyroidectomy.Methods Seventy-six patients who underwent radical thyroidectomy under general anesthesia in the People′s Hospital of Bozhou from January 2020 to June 2021 were selected as the research subjects,and they were randomly divided into observation group and control group,with 38 cases in each group.The patients in the observation group were intravenously injected 0.5μg·kg^(-1) of dexmedetomidine(diluting normal saline to 20 mL)before 10 min of anesthesia induction,and which was maintained with 0.5μg·kg^(-1)·h^(-1) until the end of the operation.The patients in the control group was pumped with 20 mL of normal saline before 10 min of anesthesia induction,and 5 mL·h^(-1) of normal saline was continuously pumped until the end of the operation.At 3 day before operation and 1,3 and 5 days after operation,the subjective sleep status of patients was evaluated by Pittsburgh sleep quality index(PSQI)and the incidence of sleep disorders was calculated,the level of orexin A in serum was detected by enzyme-linked immunosorbent assay,the quality of postoperative recovery was evaluated by 40 item recovery quality assessment scale(QoR-40).The total sleep time,recovery time,residence time in resuscitation room,anesthetic dosage and postoperative adverse reactions were compared between the two groups.Results There was no significant difference in PSQI score of patients between the two groups at 1 day before operation and 5 days after operation(P>0.05).At 1 day and 3 days after operation,the PSQI score of patients in the observation group was significantly lower than that in the control group(P<0.01).The PSQI score of patients in the two groups at 1,3 and 5 days after operation was significantly higher than that at 1 day before operation,the PSQI score of patients in the two groups at 3,5 days after operation was significantly lower than that at 1 day after operation,and the
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