氢吗啡酮联合舒芬太尼在胸腔镜肺叶切除术患者中的应用效果研究  

The Application of Hydromorphone Combined with Sufentanil in Patients with Video-assissted Thoracoscopic Lobectomy

作　　者：黄永强 HUANG Yongqiang(Anesthesiology Department,Kashgar People's Hospital,Kashgar 844000,Xinjiang Uygur Autonomous Region,China)

机构地区：[1]喀什市人民医院麻醉科,新疆维吾尔自治区喀什844000

出　　处：《中外医疗》2024年第21期5-8,24,共5页China & Foreign Medical Treatment

摘　　要：目的探讨氢吗啡酮联合舒芬太尼在胸腔镜肺叶切除术患者中的应用效果。方法方便选取2022年11月—2023年12月喀什市人民医院收治的116例行胸腔镜肺叶切除术患者为研究对象,按照不同麻醉方案分为对照组和研究组,各58例。对照组患者给予舒芬太尼麻醉,研究组患者联合应用氢吗啡酮麻醉,对比两组患者不同时刻血流动力学变化、各生理应激指标水平变化、术后镇痛效果及不良事件发生率。结果术前(T0)两组患者平均动脉压(mean arterial pressure,MAP)、心率(heart rate,HR)水平相比,差异无统计学意义(P均>0.05);在插管时(T1)、插管5 min(T2)、拔管(T3)和术毕(T4)时,研究组MAP、HR水平低于对照组,差异有统计学意义(P均<0.05)。研究组患者各项生理应激指标水平低于对照组,差异有统计学意义(P均<0.05)。术后1 h、6 h与24 h时研究组患者的视觉模拟疼痛评分量表评分均较对照组更低,差异有统计学意义(P均<0.05)。研究组患者的不良事件总发生率为5.17%(3/58)相较于对照组的17.24%(10/58)更低,差异有统计学意义(χ^(2)=4.245,P<0.05)。结论在胸腔镜肺叶切除术中给予氢吗啡酮联合舒芬太尼麻醉有助于维持血流动力学稳定,降低机体应激反应及不良事件发生风险,提高术后镇痛效果。Objective To investigate the application effect of hydromorphone combined with sufentanil in patients undergoing thoracoscopic lobectomy.Methods A total of 116 patients undergoing video-assissted thoracoscopic lobectomy admitted to Kashgar People's Hospital from November 2022 to December 2023 were conveniently selected as the research objects.According to different anesthesia schemes,they were divided into control group and study group,with 58 cases in each group.The patients in the control group were given sufentanil anesthesia,and the patients in the study group were combined with hydromorphone anesthesia.The hemodynamic changes at different times,the changes of physiological stress indexes,the postoperative analgesic effect and the incidence of adverse events were compared between the two groups.Results There was no significant difference in mean arterial pressure(MAP)and heart rate(HR)between the two groups before procedure(T0)(both P>0.05).At intubation(T1),intubation for 5 min(T2),extubation(T3)and end of operaction(T4),the MAP and HR levels in the study group were lower than those in the control group,the differences were statistically significant(all P<0.05).The levels of physiological stress indexes in the study group were lower than those in the control group,and the differences were statistically significant(all P<0.05).The scores of Visual Analogue Scale in the study group were lower than those in the control group at 1 h,6 h and 24 h after operation,and the differences were statistically significant(all P<0.05).The total incidence of adverse events in the study group was 5.17%(3/58),which was lower than that in the control group 17.24%(10/58),and the difference was statistically significant(χ^(2)=4.245,P<0.05).Conclusion Hydromorphone combined with sufentanil anesthesia in thoracoscopic lobectomy is helpful to maintain hemodynamic stability,reduce the risk of stress response and adverse events,and improve postoperative analgesia.

关 键 词：氢吗啡酮 舒芬太尼 胸腔镜肺叶切除术 血流动力学 生理应激 不良事件 

分 类 号：R614[医药卫生—麻醉学]