DEX结合纳布啡对腹腔镜胆囊切除术患者全麻苏醒期血流动力学指标的影响  

Effect of DEX Combined with Nalbuphine on Hemodynamic Indexes in Laparoscopic Cholecystectomy Patients after Recovery under General Anesthesia

作　　者：张刚 潘巧娟 ZHANG Gang;PAN Qiaojuan(Department of Anesthesiology,Shandong Yiyang Health Group Zibo Hospital,Zibo,Shandong Province,255120)

机构地区：[1]山东颐养健康集团淄博医院麻醉科,山东淄博255120 [2]淄川区医院心血管内科,山东淄博255199

出　　处：《中外医疗》2023年第21期40-43,48,共5页China & Foreign Medical Treatment

摘　　要：目的 探究对腹腔镜胆囊切除术患者给予右美托咪定(dexmedetomidine,DEX)+纳布啡麻醉方式对其苏醒期血流动力学指标的影响。方法 方便选择2020年1月—2023年1月山东颐养健康集团淄博医院的腹腔镜胆囊切除术患者98例,利用双盲法等比例分为对照组和观察组,各49例,对照组给予DEX麻醉,观察组在对照组基础上给予盐酸纳布啡注射液,对比两组血流动力学、神经系统抑制机体免疫功能、手术指标与麻醉效果、术后不同时间点镇痛效果、不良事件发生率。结果 麻醉后苏醒期,观察组各项血流动力学指标均高于对照组,差异有统计学意义(P<0.05)。手术开始8 min后观察组各项神经系统抑制机体免疫功能指标均高于对照组,差异有统计学意义(P<0.05)。观察组各项手术指标与麻醉效果评分均低于对照组,差异有统计学意义(P<0.05)。观察组术后不同时间点镇痛效果评分均低于对照组,差异有统计学意义(P<0.05)。术后观察组不良事件总发生率低于对照组(6.12%vs 20.41%),差异有统计学意义(χ^(2)=4.346,P<0.05)。结论 对腹腔镜胆囊切除术患者给予DEX+纳布啡麻醉方式可稳定患者血流动力学指标,降低手术应激和苏醒后躁动,镇痛效果更佳,总体不良事件发生率更低。Objective To explore the effect of dexmedetomidine(DEX) + nalbuphine anesthesia on hemodynamic indexes in patients undergoing laparoscopic cholecystectomy.Methods 98 patients with laparoscopic cholecystectomy in Shandong Nursing and Health Group Zibo Hospital from January 2020 to January 2023 were conveniently selected and divided into control group and observation group by double-blind method,49 cases in each group.The control group was given DEX anesthesia,and the observation group was given nbuphine hydrochloride injection on the basis of the control group.The hemodynamics,nervous system suppression of immune function,surgical indexes and anesthesia effect,postoperative analgesia effect at different time points,and incidence of adverse events were compared between the two groups.Results In the recovery period after anesthesia,the hemodynamic indexes in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).8 min after operation,the indexes of nervous system suppression of immune function in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).The surgical indexes and anesthetic effect scores of the observation group were lower than those of the control group,and the difference was statistically significant(P<0.05).The analgesic effect scores of the observation group were lower than those of the control group at different time points,and the difference was statistically significant(P<0.05).The total incidence of adverse events in the observation group was lower than that in the control group(6.12% vs 20.41%),and the difference was statistically significant(χ^(2)=4.346,P<0.05).Conclusion For laparoscopic cholecystectomy patients,DEX+ nalbuphine anesthesia can stabilize the hemodynamic indexes of patients,reduce surgical stress and agitation after recovery,have better analgesic effect,and lower the overall incidence of adverse events.

关 键 词：腹腔镜胆囊切除术 纳布啡 右美托咪定 血流动力学 

分 类 号：R614[医药卫生—麻醉学]