| 潘文星,张绍义,余云明,余承易,高德胜,刘 超.右美托咪定复合舒芬太尼自控镇痛对剖宫产产妇应激反应和炎症介质的影响[J].,2020,(13):2560-2563 |
| 右美托咪定复合舒芬太尼自控镇痛对剖宫产产妇应激反应和炎症介质的影响 |
| Effects of Dexmedetomidine Combined with Sufentanil Self Controlled Analgesia on Stress Response and Inflammatory Mediators in Cesarean Section Women |
| 投稿时间：2019-12-08 修订日期：2019-12-31 |
| DOI：10.13241/j.cnki.pmb.2020.13.034 |
| 中文关键词: 右美托咪定 舒芬太尼 自控镇痛 剖宫产 应激反应 炎症介质 |
| 英文关键词: Dexmedetomidine Sufentanil Self controlled analgesia Cesarean section Stress response Inflammatory mediators |
| 基金项目:重庆卫生计生委医学科研项目（20161288） |
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| 中文摘要: |
| 摘要 目的：探讨右美托咪定复合舒芬太尼自控镇痛对剖宫产产妇应激反应和炎症介质的影响。方法：选取2017年4月~2019年4月期间在我院行剖宫产术的产妇105例，根据乱数表法将患者分为研究组（n=53）和对照组（n=52），其中对照组采用舒芬太尼自控镇痛方案，研究组采用右美托咪定复合舒芬太尼自控镇痛方案，比较两组视觉疼痛模拟评分（VAS）、Ramsay镇静评分、应激反应和炎症介质指标，记录两组术后48 h内自控镇痛泵使用情况、镇痛期间不良反应发生情况。结果：两组术后2 h、12 h、24 h、48 h VAS评分均呈下降趋势，且研究组术后2 h、12 h、24 h、48 h VAS评分低于对照组（P<0.05），研究组术后2 h、12 h、24 h、48 h Ramsay镇静评分高于对照组（P<0.05）。两组术后48h血清皮质醇（Cor）、肿瘤坏死因子-α（TNF-α）、甲肾上腺素（NE）、C反应蛋白（CRP）、内皮素-1（ET-1）、白介素-10（IL-10）水平均升高，但研究组低于对照组（P<0.05）。研究组术后48 h内舒芬太尼用量、镇痛泵按压次数均少于对照组（P<0.05）。两组不良反应发生率比较无差异（P>0.05）。结论：采用右美托咪定复合舒芬太尼自控镇痛方案可有效减轻剖宫产产妇应激反应并降低其炎症介质水平，同时还可减少舒芬太尼用量和镇痛泵按压次数，用药安全性较好，临床应用价值较高。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of dexmedetomidine combined with sufentanil self controlled analgesia on stress response and inflammatory mediators in cesarean section women. Methods: From April 2017 to April 2019, 105 cases of parturient undergoing cesarean section in our hospital were selected. According to the method of random number table, the patients were divided into study group (n=53) and control group (n=52). The control group was given sufentanil self controlled analgesia, and the study group was dexmedetomidine combined with sufentanil self controlled analgesia on the basis of the control group. The visual pain simulation score (VAS), Ramsay sedation score, stress response and inflammatory mediators indexes were compared between the two groups. The use of automatic analgesia pump and the occurrence of adverse reactions during analgesia were recorded in the two groups within 48 h after the operation. Results: The VAS scores of the two groups were decreased at 2 h, 12 h, 24 h and 48 h after operation, and that of the study group at 2 h, 12 h, 24 h and 48 h after operation were lower than that of the control group (P<0.05). The Ramsay sedation score of the study group at 2 h, 12 h, 24 h and 48 h after operation were higher than that of the control group(P<0.05). The levels of serum cortisol (COR), tumor necrosis factor-α (TNF-α), noradrenaline (NE), C-reactive protein (CRP), endothelin -1 (ET-1) and interleukin -10 (IL-10) in the two groups decreased at 48 hours after operation, and those of the study group were lower than those of the control group(P<0.05). The dosage of sufentanil and the times of compression of analgesia pump of the study group were less than those of the control group (P<0.05). There was no difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: Dexmedetomidine combined with sufentanil self controlled analgesia can effectively reduce the body stress response and inflammatory mediators, as well as the dosage of sufentanil and the number of times of compression of analgesia pump. It has good safety, and it has a high clinical application value. |
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