麻醉诱导前经皮电刺激联合右美托咪定静脉注射对经阴道子宫切除联合阴道修补患者术后的影响  

Effect of transcutaneous electrical stimulation combined with intravenous dexmedetomidine used prior to anesthesia induction of patient with transvaginal hysterectomy combined with vaginal repair on their recovery after surgery

作　　者：宋天昊 陈晓媛 韩一 SONG Tianhao;CHEN Xiaoyuan;HAN Yi(Hebei Petro China Central Hospital,Langfang,Hebei Province,065000)

机构地区：[1]河北中石油中心医院,廊坊065000

出　　处：《中国计划生育学杂志》2024年第10期2434-2439,共6页Chinese Journal of Family Planning

基　　金：廊坊市科学技术研究与发展计划项目(2021013148)。

摘　　要：目的:探讨麻醉诱导前经皮电刺激(TENS)联合右美托咪定静脉注射对经阴道子宫切除联合阴道修补患者术后的影响。方法:选取2020年10月-2023年12月在本院行经阴道子宫切除联合阴道修补术治疗的100例患者为研究对象,采用随机数字表法分为两组。对照组在麻醉诱导前给予右美托咪定静脉注射干预,观察组麻醉诱导前给予右美托咪定静脉注射联合TENS干预。比较两组静息和咳嗽时视觉模拟(VAS)评分、排气时间、住院时间、残余尿量、舒适度(BCS)评分、疼痛应激因子水平及不良反应发生情况。结果:观察组排气时间短于对照组,两组残余尿量、住院时间比较,差异无统计学意义(P>0.05)。观察组术后4h、12h、24h、48h的静息和咳嗽VAS评分均低于对照组,BCS评分均高于对照组(P<0.05)。两组术前疼痛应激因子比较差异无统计学意义(P>0.05),两组术后24h时皮质醇(Cor)、神经肽Y(NPY)、β-内咖肽(β-EP)均较术前升高(P<0.05),术后24h观察组Cor、NPY、β-EP低于对照组(P<0.05)。观察组恶心呕吐、口干、心动过缓、皮肤瘙痒等总不良反应发生率与对照组无差异无统计学意义(P>0.05)。结论:经阴道子宫切除联合阴道修补术麻醉诱导前采用TENS复合右美托咪定静脉注射,可减少术后疼痛因子的释放,减轻疼痛,提高舒适度,从而促进术后恢复。Objective:To observe the effects of transcutaneous electrical stimulation(TENS)combined with intravenous dexmedetomidine used prior to anesthesia induction of patient with transvaginal hysterectomy combined with vaginal repair on their recovery after surgery.Methods:100 patients who wanted transvaginal hysterectomy combined with vaginal repair were selected and were divided into two groups by the random number table method from October 2020 to December 2023.The patients in the control group were given intravenous dexmedetomidine prior to anesthesia induction,and the patients in the observation group were given the combined TENS combined with intravenous dexmedetomidine prior to anesthesia induction.The visual analog(VAS)scores at resting and cough,the exhaust time,the duration of hospital stay,the residual urine volume,the comfort(BCS)score,the pain stress factor level and the occurrence of adverse reactions of the patients were compared between the two groups.Results:The exhaust time of the patients in the observation group was significantly shorter than that of the patients in the control group,and there were no statistically significant differences in the residual urine volume and the duration of hospitalization of the patients between the two groups(P>0.05).The VAS scores at resting and cough of the patients in the observation group at 4h,12h,24h and 48h after surgery were significantly lower than those of the patients in the control group,and the BCS score of the patients in the observation group at 4h,12h,24h and 48h after surgery was significantly higher(P<0.05).There was no significant difference in the pain stress factor level before surgery of the patients between the two groups(P>0.05).24hours after operation,The levels of cortisol(Cor),neuropeptide Y(NPY)andβ-endophytin(β-EP)of the patients in the two groups after surgery had increased significantly(P<0.05),and which of the patients in the observation group at 24 hours after surgery were significantly lower than those of the patients in the control

关 键 词：经阴道子宫切除 阴道修补术 经皮电刺激 右美托咪定 疼痛 舒适度 

分 类 号：R713[医药卫生—妇产科学]