右美托咪定对择期剖宫产产妇术后睡眠质量及并发症的影响  

Effect of dexmedetomidine on postoperative sleep quality and complications in women undergoing elective cesarean delivery

作　　者：游意莹 钟伟龙 王艳玲[1] 李利平 YOU Yiying;ZHONG Weilong;WANG Yanling;LI Liping(Department of Anesthesiology,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院麻醉科,广东广州510630

出　　处：《新医学》2025年第2期190-196,共7页Journal of New Medicine

基　　金：广东省自然科学基金(2023A1515010288)。

摘　　要：目的探讨右美托咪定对择期剖宫产产妇术后睡眠质量及并发症的影响。方法选取行择期剖宫产的产妇180例,随机分为右美托咪定组(D组)和对照组(C组),每组90例。从胎儿取出后15 min内分别泵注右美托咪定0.5μg/kg(D组)或10 mL生理盐水。通过匹兹堡睡眠质量指数(PSQI)量表和失眠严重程度指数(ISI)评估术后24、48 h及出院前1天产妇的睡眠状况,采用视觉模拟评分(VAS)记录2组产妇术后24 h和48 h静息疼痛及活动疼痛情况;记录产妇围术期其他并发症情况。结果D组产妇术后24、48 h及出院前1天的PSQI评分及ISI评分均低于C组产妇(均P<0.05),D组产妇术后24 h重度睡眠障碍及失眠的发生率低于C组产妇(P=0.031、0.021)。D组产妇术后24、48 h的静息疼痛及活动疼痛均较轻,术后PCEA按压的次数也较少(均P<0.05)。D组产妇术后恶心呕吐、皮肤瘙痒并发症的发生率较低,术后首次下地时间、术后住院时间较短,住院期间的满意度较高,产后6周抑郁发生率也较低(均P<0.05)。结论右美托咪定能改善剖宫产产妇术后的睡眠质量,减轻术后疼痛及并发症的发生。Objective To evaluate the effect of dexmedetomidine on postoperative sleep quality and complications in women undergoing elective cesarean delivery.Methods 180 women undergoing elective cesarean delivery were selected and randomly divided into the dexmedetomidine group(group D)and control group(group C),90 cases in each group.Dexmedetomidine 0.5μg/kg(group D)or 10 mL of 0.9%sodium chloride injection was pumped within 15 min after fetal extraction.Maternal sleep status was assessed by Pittsburgh Sleep Quality Index(PSQI)and Insomnia Severity Index(ISI)for 24 h,48 h postoperatively and 1 day before discharge.Maternal resting pain and activity-induced pain at 24 h and 48 h postoperatively were recorded by visual analog score(VAS)in both groups.Other perioperative complications of labor were recorded.Results The PSQI scores and ISI scores of the women in group D were lower than those of the women in group C at 24 h,48 h after surgery and 1 day before discharge(all P<0.05).The incidence of severe sleep disorders and insomnia at 24 h postoperatively was lower in group D than that in group C(P=0.031 and P=0.021).The women in group D had less resting pain and activity-induced pain at 24 h and 48 h postoperatively,and the number of postoperative PCEA compressions was also lower(all P<0.05).The incidence of postoperative nausea and vomiting,itchy skin complications was lower in group D.The time to first postoperative activity,the length of postoperative hospital stay was shorter,degree of satisfaction during hospitalization was higher,and the incidence of depression at 6 weeks postpartum was also lower(all P<0.05).Conclusion Dexmedetomidine improves sleep quality after cesarean delivery,reduces postoperative pain and complications.

关 键 词：右美托咪定 剖宫产 睡眠障碍 术后疼痛 产后抑郁 并发症 

分 类 号：R47[医药卫生—护理学]