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舒芬太尼联合右美托咪定对子宫切除术后患者SIRS评分及睡眠的影响
作者:谭兴中1  岳永猛1  王炎1  焦艳玲1  赵俊锦1  陈力1  张冲1  徐庆2  杨贵岚3 
单位:1. 巴中市中心医院 麻醉科, 四川 巴中 636000;
2. 北京协和医院 麻醉科, 北京 100032;
3. 巴中市中心医院 超声科, 四川 巴中 636000
关键词:舒芬太尼 右美托咪定 子宫切除术 全身炎症反应综合征 睡眠 
分类号:R713.42;R971.2
出版年·卷·期(页码):2019·38·第三期(402-406)
摘要:

目的:探讨舒芬太尼联合右美托咪定对行经腹子宫切除术后患者全身炎症反应综合征(SIRS)评分及睡眠质量的影响。方法:选取72例行经腹全子宫切除术患者,随机分为联合使用舒芬太尼、右美托咪定的联合用药组和单独使用舒芬太尼的单独用药组两组各36例。比较两组患者术前1夜、术后第1夜和术后第2夜连续3夜21:00~次日6:00快速动眼睡眠(REM)和非REM各期所占时长比、主观睡眠质量及睡眠效率。比较两组患者术后SIRS评分。结果:单独用药组术后第1夜、第2夜非REMⅠ期占时比较术前1夜显著升高(P<0.05),联合用药组非REMⅡ期占时比显著提高(P<0.05);两组患者术后第1夜、第2夜的REM占时比显著低于术前1夜(P<0.05),组间比较则差异无统计学意义(P>0.05);两组患者术后第1夜、第2夜的非REM慢波睡眠期睡眠占时比、睡眠效率、觉醒指数以及主观睡眠质量显著低于术前1夜(P<0.05),组间比较差异也有统计学意义(P<0.05);联合用药组患者术后SIRS评分显著低于单独用药组(P<0.05)。结论:对行经腹子宫切除术后睡眠剥夺的患者,联合使用舒芬太尼和右美托咪定较之单独使用舒芬太尼,能下调SIRS评分,同时更好地改善睡眠质量。

Objective:To investigate the effect of sufentanil combined with dexmedetomidine on systemic inflammatory response syndrome(SIRS) score and sleep quality of patients after abdominal hysterectomy. Methods:Seventy-two patients with abdominal hysterectomy were selected and randomly divided into two groups,i.e., the combined group(sufentanil and dexmedetomidine) and the single group(sufentanil)with 36 cases in each group. The sleep distribution(non-REM sleep phases and REM sleep phases), subjective sleep quality and sleep efficiency of the two groups were compared for 3 consecutive nights(21:00 in the evening to 6:00 the next day of 1 night before surgery, 1 and 2 nights after surgery). The SIRS scores of the two groups were compared. Results:The sleep of non-rapid eye movement stage I was significantly higher in the single drug group on the first night and the second night after surgery than that on the night before surgery(P<0.05), while the sleep of non-rapid eye movement stage Ⅱ was significantly higher in the combined drug group(P<0.05). The rapid eye movement period on the first and the second night after surgery was significantly lower than that on the night before surgery(P<0.05), but there was no statistical difference between the two groups(P>0.05). The sleep, sleep efficiency, arousal index and subjective sleep quality in slow wave sleep phase of non-rapid eye movement sleep on the first and the second night after operation of the two groups were significantly lower than those on the night before operation(P<0.05), and there were statistically significant differences between the two groups(P<0.05). Compared with the single drug group, the postoperative SIRS score in the combined drug group was significantly lower(P<0.05). Conclusion:For patients with sleep deprivation after abdominal hysterectomy, combined administration of sufentanil and dexmedetomidine can lower SIRS score and improve sleep quality, which is better than single administration.

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