摘要
目的探讨右美托咪定鼻喷雾剂(dexmedetomidine nasal spray,DNS)对子宫切除术患者围手术期睡眠质量、焦虑应激的影响。方法选取2024年5月至12月于台州市第一人民医院行腹腔镜子宫切除术患者75例,根据随机数字表法将其分为对照组(37例)和试验组(38例)。试验组患者分别于术前1晚及术后当晚20:30鼻喷DNS 50μg或75μg,对照组患者分别于术前1晚及术后当晚20:30鼻喷等容量生理盐水。观察并比较两组患者入院第1晚(T_(0))、术前1晚(T_(1))、术后当晚(T_(2))及术后第2晚(T_(3))的阿森斯失眠量表(Athens insomnia scale,AIS)评分及睡眠质量,入院第1天、入手术室前、术后第1天、第2天的医院焦虑抑郁量表(hospital anxiety and depression scale,HADS)、唾液皮质醇和α-淀粉酶水平及给药后60min不良反应发生率。结果与对照组相比,试验组患者T_(1)、T_(2)、T_(3)时点的AIS评分显著降低,入睡潜伏期明显缩短,总睡眠时间、非快速眼动睡眠时间显著延长,快速眼动睡眠时间显著缩短(P<0.05),T_(1)、T_(2)时点的觉醒次数明显减少(P<0.05),入手术室前、术后第1天、第2天的HADS评分、唾液皮质醇和α-淀粉酶水平均显著降低(P<0.05)。两组患者给药后60min内不良反应发生率比较差异无统计学意义(P>0.05)。结论DNS围手术期给药可明显改善腹腔镜子宫切除术患者的睡眠质量,缓解焦虑情绪,降低应激水平,且安全性高。
Objective To explore the effect of dexmedetomidine nasal spray(DNS)on perioperative sleep quality,anxiety stress in patients undergoing hysterectomy.Methods A total of 75 patients who underwent laparoscopic hysterectomy at Taizhou First People’s Hospital from May to December 2024 were selected and divided into control group(37 cases)and experimental group(38 cases)according to the random number table method.Patients in experimental group were respectively sprayed with 50μg or 75μg of DNS at 20:30 on the night before surgery and the night after surgery,patients in control group were respectively given an equal volume of normal saline nasal spray at 20:30 on the night before surgery and the night after surgery.Athens insomnia scale(AIS)scores and sleep quality on the first night of admission(T0),the first night before surgery(T_(1)),the first night after surgery(T_(2)),and the second night after surgery(T_(3)),the scores of hospital anxiety and depression scale(HADS),salivary cortisol andα-amylase on the first day of admission,before entering the operating room,and on the first and second days after surgery,and incidence of adverse reactions 60 minutes after administration between two groups of patients were observed and compared.Results Compared with control group,the AIS scores in experimental group at T_(1),T_(2)and T_(3)were significantly lower,the latency to sleep was significantly shortened,the total sleep time and non-rapid eye movement sleep time were significantly prolonged,and rapid eye movement sleep time was significantly shortened(P<0.05),number of awakenings at T_(1)and T_(2)decreased significantly(P<0.05),and HADS score,salivary cortisol andα-amylase levels before entering the operating room,and on the first and second days after surgery were all significantly decreased(P<0.05).There was no statistically significant difference in the incidence of adverse reactions within 60 minutes after administration between two groups of patients(P>0.05).Conclusion Perioperative administration of DNS can significantly improve the sleep quality of patients undergoing laparoscopic hysterectomy,relieve anxiety,reduce stress levels,and has high safety.
作者
郑芝
杨亦平
丁依依
王阳阳
王文伟
李军
ZHENG Zhi;YANG Yiping;DING Yiyi;WANG Yangyang;WANG Wenwei;LI Jun(Department of Anesthesiology,Taizhou First People’s Hospital,Taizhou 318020,Zhejiang,China;Department of Anesthesiology and Perioperative Medicine,the Second Affiliated Hospital of Wenzhou Medical University,Wenzhou 325027,Zhejiang,China)
出处
《中国现代医生》
2025年第22期73-76,108,共5页
China Modern Doctor
