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| 右美托咪定对开腹胃肠肿瘤手术患者术后睡眠质量与心理状态的影响 |
| Effect of dexmedetomidine on postoperative sleep and psychology in patients undergoing open abdominal gastrointestinal tumor surgery |
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| DOI：10.12089/jca.2019.09.007 |
| 中文关键词: 右美托咪定 胃肠肿瘤 术后康复 焦虑和抑郁 睡眠剥夺 |
| 英文关键词: Dexmedetomidine Gastrointestinal tumor Postoperative rehabilitation Anxiety and depression Sleep deprivation |
| 基金项目:湖南省卫计委科研计划项目(B2017028) |
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| 中文摘要: |
目的 探讨右美托咪定对开腹胃肠手术患者术后睡眠质量与心理状态的影响。
方法 择期行胃肠肿瘤手术患者50例,男25例,女25例,年龄>50岁,BMI 18～30 kg/m2,ASA Ⅱ或Ⅲ级，将患者随机分为两组,分别从麻醉诱导前15 min开始持续泵注生理盐水(C组)或右美托咪定0.2 μg·kg-1·h-1(D组),直至手术结束前30 min。术中采用丙泊酚和瑞芬太尼全凭静脉麻醉,术后行舒芬太尼PCIA。记录术前及术后阿森斯睡眠量表(AIS)评分、广泛性焦虑障碍量表(GAD-7)评分和抑郁症筛查量表(PHQ-9)评分;记录术后PCA按压次数以及术后相关并发症等。
结果 D组术后第1天［11.0(10.0～13.0)分 vs 15.0(13.5～16.0)分］、第3天［7.0(6.5～8.0)分 vs 9.0(8.0～10.0)分］和第7天［5.0(5.0～6.0)分 vs 6.0(5.0～6.0)分］AIS评分均明显低于C组(P<0.05)。D组术后第7天［6.0(5.5～6.5)分 vs 7.0(6.0～7.0)分］和第30天［6.0(5.0～6.0)分 vs 7.0(6.0～7.0)分］GAD-7评分明显低于C组(P<0.05)。D组术后第30天PHQ-9评分明显低于C组［7.0(7.0～8.0)分 vs 8.0(8.0～9.0)分,P<0.05］。D组术后PCA按压次数明显少于C组［(3.6±1.7)次 vs (6.1±1.9)次, P<0.05］。两组患者术后并发症差异无统计学意义。
结论 右美托咪定能改善开腹胃肠手术患者术后睡眠质量和心理健康，可能有利于促进术后恢复。 |
| 英文摘要: |
Objective To study the effects of dexmedetomidine on postoperative sleep quality and psychological status in patients undergoing open abdominal surgery.
Methods Fifty patients undergoing gastrointestinal tumor surgery were selected including 25 males and 25 females, aged > 50 years and with a BMI 18-30 kg/m2. Patients were randomly divided into saline (group C) or dexmedetomidine 0.2 μg·kg-1·h-1 (group D). Continuous pumping was starting 15 minutes before anesthesia induction until 30 min before the end of surgery. Intraoperative intravenous anesthesia with propofol and remifentanil was performed, and sufentanil PCIA was performed after operation. The Athens Insomnia Scale (AIS) score, Generalized Anxiety Disorder (GAD-7) score, and Patient Health Questionnaire (PHQ-9) score were recorded; as well as postoperative PCA compressions and postoperative complications were recorded.
Results Compared with group C, the postoperative AIS scores ［1st day: 11.0 (10.0-13.0), 3rd day: 7.0 (6.5-8.0), 7th day: 5.0 (5.0-6.0)］, postoperative GAD-7 scores ［7th day: 6.0 (5.5-6.5), 30th day: 6.0 (5.0-6.0)］ and PHQ-9 score ［postoperative 30th day: 7.0 (7.0-8.0)］ in group D were significantly lower (all P < 0.05), as well as postoperative PCA compressions (3.6±1.7 vs 6.1±1.9) were significantly reduced (P < 0.05).
Conclusion Dexmedetomidine can improve the quality of postoperative recovery and promote rehabilitation in patients undergoing open abdominal surgery. |
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