盐酸纳布啡联合右美托咪定对腹腔镜胆囊术后患者血流动力学、疼痛视觉模拟评分及Ramsay镇静评分的影响  

Effects of nalbuphine hydrochloride combined with dexmedetomidine on hemodynamics,VAS score,and Ramsay sedation score after laparoscopic cholecystectomy.

作　　者：石磊[1] 马玉林[1] 方圆 周银芳 SHI Lei;MA Yu-lin;FANG Yuan;ZHOU Yin-fang(Department of Anesthesiology,Department of Clinical Laboratory,Ankang 725000,Shaanxi,CHINA;Department of Anesthesiology,Ankang Central Hospital,Ankang 725000,Shaanxi,CHINA)

机构地区：[1]安康市中心医院麻醉科,陕西安康725000 [2]安康市中心医院检验科,陕西安康725000

出　　处：《海南医学》2022年第21期2745-2748,共4页Hainan Medical Journal

基　　金：陕西省安康市卫生健康委员会计划项目(编号:2018AK03-19)。

摘　　要：目的研究盐酸纳布啡联合右美托咪定对腹腔镜胆囊手术后患者血流动力学、疼痛视觉模拟评分及Ramsay镇静评分的影响。方法选取2019年8至2021年9月期间安康市中心医院收治的128例行腹腔镜胆囊术后自控静脉镇痛患者为研究对象。按照随机数表法分为研究组和对照组各64例。对照组患者术后采用右美托咪定镇痛,研究组患者术后采用盐酸纳布啡联合右美托咪定镇痛。在术后2 h及术后24 h,比较两组患者的手术时间、拔管时间、定向力恢复时间、住院时间、术后血流动力学指标[心率(HR)、舒张压(DBP)、收缩压(SBP)]、疼痛视觉模拟(VAS)评分及Ramsay镇静评分和术后并发症发生情况。结果研究组和对照组患者的手术时间分别为(56.23±12.54)min,(58.21±13.14)min,差异无统计学意义(P>0.05);研究组患者的拔管时间、定向力恢复时间、住院时间分别为(6.98±1.02)min、(8.92±1.06)min、(6.32±1.02)d,明显短于对照组的(15.62±0.95)min、(14.23±2.31)min、(9.36±1.43)d,差异均有统计学意义(P<0.05);术后2 h,两组患者的HR、DBP、SBP比较差异均无统计学意义(P>0.05);术后24 h,两组患者的HR、SBP、DBP较术后2 h均明显降低,且研究组患者的HR、SBP、DBP分别为(76.28±4.92)min/次、(121.23±7.63)mmHg、(66.29±10.24)mmHg,明显低于对照组患者的(82.26±8.62)min/次、(128.26±11.32)mmHg、(70.43±10.19)mmHg,差异均有统计学意义(P<0.05);术后2 h,两组患者的VAS评分、Ramsay评分比较差异无统计学意义(P>0.05);术后24 h,两组患者的VAS评分较术后2 h均明显降低,且研究组患者的VAS评分为(2.3±0.5)分,明显低于对照组患者的(4.2±0.6)分,差异有统计学意义(P<0.05);术后24 h,两组患者的Ramsay评分较术后2 h均明显升高,且研究组患者的Ramsay评分为(3.6±0.4)分,明显高于对照组患者的(3.1±0.1)分,差异均有统计学意义(P<0.05);研究组患者术后并发症发生率为7.81%,明显低于对照组的Objective To study the effects of nalbuphine hydrochloride combined with dexmedetomidine on hemodynamics,Visual Analogue Scale(VAS)Score,and Ramsay sedation score in patients after laparoscopic cholecystectomy.Methods A total of 128 patients undergoing patient-controlled intravenous analgesia after laparoscopic cholecystectomy admitted to Ankang Central Hospital from August 2019 to September 2021 were selected as the study subjects.According to the random number table method,they were divided into the study group and the control group,each with 64 patients.Patients in the control group were given dexmedetomidine for analgesia after operation,and those in the study group were given nalbuphine hydrochloride combined with dexmedetomidine for analgesia after operation.At 2 h and 24 h after operation,the operation time,extubation time,recovery time of directional force,length of hospital stay,postoperative hemodynamic indexes[heart rate(HR),diastolic blood pressure(DBP),systolic blood pressure(SBP)],VAS score,Ramsay sedation score,and postoperative complications were recorded and compared between the two groups.Results The operation time in the study group and the control group were(56.23±12.54)min and(58.21±13.14)min,respectively,with no statistically significant difference(P>0.05).The extubation time,recovery time of directional force,and length of hospital stay in the study group were(6.98±1.02)min,(8.92±1.06)min,and(6.32±1.02)d,respectively,which were significantly shorter than(15.62±0.95)min,(14.23±2.31)min,and(9.36±1.43)d in the control group(P<0.05).At 2 h after operation,there was no significant difference in HR,DBP,and SBP between the two groups(P>0.05);at 24 hours after operation,HR,SBP,and DBP of the two groups were significantly decreased,and the levels of the study group were(76.28±4.92)min/time,(121.23±7.63)mmHg,(66.29±10.24)mmHg,which were significantly lower than(82.26±8.62)min/time,(128.26±11.32)mmHg,(70.43±10.19)mmHg of the control group(P<0.05).At 2 h after operation,there was no signi

关 键 词：盐酸纳布啡 右美托咪定 腹腔镜 胆囊术 血流动力学 镇静 镇痛 

分 类 号：R657.4[医药卫生—外科学]