舒芬太尼联合右美托咪定在髌骨骨折患者经皮穿刺张力带固定术中麻醉的应用及对患者苏醒质量的影响
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摘要
目的探讨舒芬太尼联合右美托咪定在髌骨骨折患者经皮穿刺张力带固定手术中麻醉的应用及对患者苏醒质量的影响。方法选取该院2016年1月至2017年1月收治的髌骨骨折患者共120例作为研究对象,按照随机数字表法分为对照组(n=60)和研究组(n=60),对照组给予舒芬太尼治疗,研究组在对照组基础上给予右美托咪定治疗,比较两组患者治疗后的临床效果、视觉模拟评分(VAS评分)、不良反应发生情况、镇静评分(Ramsay评分)及血流动力学情况。结果治疗后研究组患者治疗有效率明显高于对照组,差异有统计学意义(P<0.05);研究组患者治疗后8h镇痛评分明显低于对照组,差异有统计学意义(P<0.05);研究组患者不良反应发生率明显低于对照组,差异有统计学意义(P<0.05);研究组患者治疗24h后镇静效果明显优于对照组,差异有统计学意义(P<0.05);研究组患者红细胞聚集指数、全血高切黏度、全血低切黏度、纤维蛋白原水平均低于对照组,差异均有统计学意义(P<0.05)。结论舒芬太尼联合右美托咪定在髌骨骨折患者经皮穿刺张力带固定手术中麻醉应用效果明显,对患者苏醒质量有积极影响,临床价值突出,值得在临床进一步推广应用。
Objective To investigate the application of sufentanil combined with dexmedetomidine in percutaneous tension band fixation for patellar fracture and its effect on the recovery quality of patients.MethodsA total of 120 patients with patellar fracture admitted to our hospital from January 2016 to January 2017 were selected as the research object.They were randomly divided into control group(n=60)and research group(n=60)according to the digital table method.The control group was treated with sufentanil,and the research group was treated with dexmedetomidine on the basis of the control group.The clinical effect,VAS score,incidence of adverse reactions,sedation score(Ramsay score)and hemodynamics of the patients after treatment.Results After treatment,the effective rate of treatment in the study group was significantly higher than that in the control group(P<0.05).The analgesic score in the study group was significantly lower than that in the control group(P<0.05).The incidence of adverse reactions in the study group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).The sedative effect of the study group was significantly better than that of the control group after 24 hours of treatment(P<0.05).The erythrocyte aggregation index,whole blood high shear viscosity,whole blood low shear viscosity and fibrinogen of the study group were lower than those of the control group,with a statistical significance(P<0.05).Conclusion Sufentanil combined with dexmedetomidine has a significant clinical effect in the application of anesthesia during the percutaneous tension band fixation for patellar fracture patients.It has a positive effect on the quality of recovery of patients and the clinical value is outstanding.It is worthy of further clinical application.
Objective To investigate the application of sufentanil combined with dexmedetomidine in percutaneous tension band fixation for patellar fracture and its effect on the recovery quality of patients.MethodsA total of 120 patients with patellar fracture admitted to our hospital from January 2016 to January 2017 were selected as the research object.They were randomly divided into control group(n=60)and research group(n=60)according to the digital table method.The control group was treated with sufentanil,and the research group was treated with dexmedetomidine on the basis of the control group.The clinical effect,VAS score,incidence of adverse reactions,sedation score(Ramsay score)and hemodynamics of the patients after treatment.Results After treatment,the effective rate of treatment in the study group was significantly higher than that in the control group(P<0.05).The analgesic score in the study group was significantly lower than that in the control group(P<0.05).The incidence of adverse reactions in the study group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).The sedative effect of the study group was significantly better than that of the control group after 24 hours of treatment(P<0.05).The erythrocyte aggregation index,whole blood high shear viscosity,whole blood low shear viscosity and fibrinogen of the study group were lower than those of the control group,with a statistical significance(P<0.05).Conclusion Sufentanil combined with dexmedetomidine has a significant clinical effect in the application of anesthesia during the percutaneous tension band fixation for patellar fracture patients.It has a positive effect on the quality of recovery of patients and the clinical value is outstanding.It is worthy of further clinical application.
引文
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[10]冉菊红,刘宏建,王艳萍,等.右美托咪定复合舒芬太尼对颈椎损伤患者清醒气管插管中应激反应的影响[J].中华实验外科杂志,2016,33(2):534-537.
[11]郭宗锋,张法强.不同剂量右美托咪定伍用舒芬太尼在隐匿性阴茎延长术患儿术后静脉镇痛中的应用比较[J].中国现代医学杂志,2016,26(22):104-107.
[12]张焕焕,李阳,滕秀飞,等.右美托咪定复合舒芬太尼用于妇科腹腔镜手术患者术后镇痛的效果观察[J].中国医科大学学报,2016,45(4):333-336.
[13]金丹,白云,吴辉.右美托咪定辅助舒芬太尼镇痛对CPB下心脏瓣膜置换术后病人应激反应和炎性反应的影响[J].中华麻醉学杂志,2016,36(1):49-52.
[14]丁艳琼,王建荣,高玲.体外循环心脏手术后患儿应用右美托咪定镇静拔除气管插管的效果观察[J].解放军医学院学报,2016,37(6):607-610.
[2]任春光,李长莹,高秀娟,等.联合应用右美托咪定和舒芬太尼对尼古丁高依赖患者食管癌术后镇痛效果的影响[J].实用医学杂志,2016,32(1):54-57.
[3]蒋明浩,王云姣,郭曲练.老年患者腰椎术后应用右美托咪定对舒芬太尼术后镇痛的影响[J].中国现代医学杂志,2017,27(18):106-109.
[4]王晶,马艳丽.舒芬太尼复合右美托咪定在额部占位切除术术后镇痛的安全性与有效性[J].临床麻醉学杂志,2016,32(1):50-52.
[5] YE L,XIAO X,ZHU L.The Comparison of Etomidate and Propofol Anesthesia in Patients Undergoing Gastrointestinal Endoscopy:A Systematic Review and Meta-Analysis[J].Surg Laparosc Endosc Percutan Tech,2017,27(1):1-7.
[6]唐润栋,徐晓林,姜彦,等.右美托咪定复合舒芬太尼术后镇痛对经腹子宫切除术患者睡眠质量的影响[J].临床麻醉学杂志,2017,33(3):222-225.
[7] CHERIAN T S,SHRADER P,FONAROW G C,et al.Effect of Atrial Fibrillation on Mortality,Stroke Risk,and Quality-of-Life Scores in Patients With Heart Failure(from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation[ORBIT-AF])[J].Am J Cardiol,2017,119(11):1763-1769.
[8]储浩,张野,王胜斌.不同剂量右美托咪啶联合罗哌卡因髂筋膜间隙阻滞在全髋关节置换术中的应用[J].实用医学杂志,2017,33(10):1673-1677.
[9] BHAVSAR R,RYHAMMER P K,GREISEN J,et al.Remifentanil Compared With Sufentanil Does Not Enhance Fast-Track Possibilities in Cardiac Surgery-A Randomized Study[J].J Cardiothorac Vasc Anesth,2016,30(5):1212-1220.
[10]冉菊红,刘宏建,王艳萍,等.右美托咪定复合舒芬太尼对颈椎损伤患者清醒气管插管中应激反应的影响[J].中华实验外科杂志,2016,33(2):534-537.
[11]郭宗锋,张法强.不同剂量右美托咪定伍用舒芬太尼在隐匿性阴茎延长术患儿术后静脉镇痛中的应用比较[J].中国现代医学杂志,2016,26(22):104-107.
[12]张焕焕,李阳,滕秀飞,等.右美托咪定复合舒芬太尼用于妇科腹腔镜手术患者术后镇痛的效果观察[J].中国医科大学学报,2016,45(4):333-336.
[13]金丹,白云,吴辉.右美托咪定辅助舒芬太尼镇痛对CPB下心脏瓣膜置换术后病人应激反应和炎性反应的影响[J].中华麻醉学杂志,2016,36(1):49-52.
[14]丁艳琼,王建荣,高玲.体外循环心脏手术后患儿应用右美托咪定镇静拔除气管插管的效果观察[J].解放军医学院学报,2016,37(6):607-610.