摘要
目的探索不同剂量右美托咪定复合舒芬太尼对股骨颈骨折患者的麻醉效果。方法选取2020年1月至2022年8月丰城市人民医院收治的99例股骨颈骨折患者作为研究对象,按照右美托咪定剂量的不同分为低剂量组(0.25μg/kg)、中剂量组(0.50μg/kg)、高剂量组(1.00μg/kg),每组33例。比较3组血流动力学指标、镇痛情况、脑保护效应指标、T淋巴细胞亚群指标、不良反应发生情况。结果气管插管即刻(T1)、手术开始40 min时(T2)、手术结束时(T3),中剂量组平均动脉压(mean arterial pressure,MAP)均高于低剂量组和高剂量组,心率(heart rate,HR)均快于低剂量组和高剂量组,差异有统计学意义(P<0.05),而低剂量组与高剂量组MAP、HR比较差异无统计学意义。术后2、6、12、24 h,高剂量组及中剂量组视觉模拟评分法(visual analog scale,VAS)评分均低于低剂量组,且高剂量组低于中剂量组,差异均有统计学意义(P<0.05)。术后3 d,高剂量组、中剂量组S100β蛋白、神经元特异性烯醇化酶(neuron-specific enolase,NSE)水平均低于低剂量组,脑氧摄取率(cerebral oxygen uptake rate,CERO 2)水平均高于低剂量组,差异有统计学意义(P<0.05);高剂量组S100β蛋白、NSE水平均低于中剂量组,CERO_(2)水平高于中剂量组,差异有统计学意义(P<0.05)。术后3 d,高剂量组、中剂量组CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)均高于低剂量组,差异有统计学意义(P<0.05),但中剂量组、高剂量组比较差异无统计学意义。3组不良反应发生率比较差异有统计学意义(P<0.05),其中,高剂量组不良反应发生率高于低剂量组,差异有统计学意义(P<0.017),其他组间两两比较差异无统计学意义。结论对于股骨颈骨折患者,中、高剂量的右美托咪定复合舒芬太尼均具较佳的镇痛效果,但中剂量右美托咪定的安全性较高。
Objective To explore the anesthetic effect of different doses of dexmedetomidine combined with sufentanil on patients with femoral neck fracture.Methods A total of 99 cases of femoral neck fracture treated in Fengcheng People's Hospital from January 2020 to August 2022 were selected as the research subjects,and they were divided into the low-dose group(0.25μg/kg),medium-dose group(0.50μg/kg)and the high-dose group(1.00μg/kg)according to the difference of dexmedetomidine dosage,with 33 cases in each group.Hemodynamics,analgesia,index of brain protective effect,index of T lymphocyte subsets and occurrence of adverse reactions were compared among the three groups.Results Immediately after tracheal intubation(T1),40 min after the start of the surgery(T2)and at the end of the surgery(T3),mean arterial pressure(MAP)in the medium-dose group were higher than those in the low-dose group and the high-dose group,and the heart rate(HR)were faster than those in the low-dose group and the high-dose group,and the differences were statistically significant(P<0.05),while there were no significant differences in MAP and HR between the low-dose group and the high-dose group.At 2,6,12 and 24 h after surgery,the visual analog scale(VAS)score in the high-dose group and the medium-dose group were lower than that in the low-dose group,and the high-dose group was lower than that in the medium-dose group,and the differences were statistically significant(P<0.05).3 d after surgery,S100βprotein and neuron-specific enolase(NSE)levels in the high-dose group and the medium-dose group were lower than those in the low-dose group,and cerebral oxygen uptake rate(CERO_(2))levels were higher than those in the low-dose group,and the differences were statistically significant(P<0.05);the levels of S100βprotein and NSE in the high-dose group were lower than those in the medium-dose group,and the levels of CERO_(2) were higher than those in the medium-dose group,and the differences were statistically significant(P<0.05).3 d after surgery,the levels of CD3^(+),CD4^(+) and CD4^(+)/CD8^(+) in the high-dose group and the medium-dose group were higher than those in the low-dose group,and the differences were statistically significant(P<0.05),while there was no statistically significant difference between the medium-dose group and the high-dose group.There was statistically significant difference in the incidence of adverse reactions among the three groups(P<0.05),among them,the incidence of adverse reactions in the high-dose group was higher than that in the low-dose group,and the difference was statistically significant(P<0.017);there was no statistically significant difference in pairwise comparisons among the other groups.Conclusion For patients with femoral neck fracture,middle and high doses of dexmedetomidine combined with sufentanil have better analgesic effect,but comprehensive evaluation shows that the safety of middle dose dexmedetomidine is higher.
作者
杨凯
王晖
甘文鹉
YANG Kai;WANG Hui;GAN Wenwu(Department of Anesthesiology,Fengcheng People's Hospital,Yichun,Jiangxi,331100,China)
出处
《当代医学》
2025年第2期5-10,共6页
Contemporary Medicine
关键词
股骨颈骨折
右美托咪定
不同剂量
舒芬太尼
麻醉效果
Femoral neck fracture
Dexmedetomidine
Different doses
Sufentanil
Anesthetic effects
