摘要
目的:探讨纳布啡复合丙泊酚对股骨颈骨折手术患者苏醒期躁动及血清炎症因子水平的影响。方法:选取2022年11月至2024年12月兰考县中心医院拟行股骨颈骨折手术的80例患者进行前瞻性研究,按照随机信封法分为对照组和观察组,每组40例。两组均给予丙泊酚、罗库溴铵行麻醉诱导,对照组给予舒芬太尼麻醉,观察组给予纳布啡麻醉。比较两组术后2 h,6 h,12 h,24 h,48 h的静态和动态视觉模拟评分(VAS),麻醉前(t_(0))、插管时(t_(1))、切皮时(t_(2))、缝皮时(t_(3))、拔管后5 min(t_(4))的心率、收缩压、舒张压,术前和术后6 h,12 h,24 h的C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)水平及术后相关指标(苏醒时间、丙泊酚用量、Riker镇静-躁动评分、苏醒期躁动发生率)。结果:观察组术后2 h,6 h,12 h的静态VAS和动态VAS评分低于对照组,差异有统计学意义(P<0.05)。两组t_(0),t_(1),t_(2),t_(3),t_(4)的心率、收缩压、舒张压比较,差异无统计学意义(P>0.05)。两组t_(1),t_(2),t_(3)的心率、收缩压高于本组t_(0),舒张压低于本组t_(0),差异有统计学意义(P<0.05)。两组术后6 h,12 h,24 h的CRP,TNF-α,IL-6,IL-1β水平均高于术前,但观察组低于对照组,差异有统计学意义(P<0.05)。观察组丙泊酚用量少于对照组,Riker镇静-躁动评分和苏醒期躁动发生率低于对照组,差异有统计学意义(P<0.05)。结论:纳布啡复合丙泊酚用于股骨颈骨折术中不仅可抑制患者术后疼痛及炎症因子释放,还可减少药物用量及苏醒期躁动。
Objective:To investigate the effect of nalbuphine combined with propofol on agitation during the awakening period and serum inflammatory factor levels of patients undergoing femoral neck fracture surgery.Methods:Eighty patients who were scheduled to undergo femoral neck fracture surgery in lankao central hospital from November 2022 to December 2024 were selected.Patients were divided into two groups according to the random envelope method,with 40 cases in each group.Both groups were given propofol and rocuronium for anesthesia induction,with the control group additionally receiving sufentanil anesthesia and the experimental group additionally receiving nalbuphine anesthesia.The static and dynamic visual analog scale(VAS)at_(2),6,12,24 and 48 hours after surgery,the heart rate,systolic blood pressure,diastolic blood pressure before anesthesia(t_(0)),during intubation(t_(1)),during skin incision(t_(2)),during skin suturing(t_(3)),and 5 minutes after extubation(t_(4)),as well as C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-1β(IL-1β)levels before surgery,6 hours,12 hours,and 24 hours after surgery,and postoperative indicators(recovery time,propofol dose,Riker sedation-agitation score,incidence of agitation during the awakening period)were compared between the two groups.Results:The static and dynamic VAS scores of the experimental group at_(2),6,and 12 hours after surgery were lower than those of the control group,there was significient difference(P<0.05).There were no significant differences in heart rate,systolic blood pressure,and diastolic blood pressure between the two groups at t_(0),t_(1),t_(2),t_(3),there was no significient difference(P>0.05).The heart rate,systolic blood pressure and diastolic blood pressure of t_(1),t_(2) and t_(3) in two groups were higher than that of t0 in this group,and the difference was statistically significant(P<0.05).The levels of CRP,TNF-α,IL-6,and IL-1βin both groups at 6,12,and 24 hours after surgery were higher than those before surgery,but the experimental group was lower than the control group(P<0.05).The dosage of propofol in the observation group was less than that in the control group,and the Riker sedation-agitation score and the incidence of agitation during awakening were lower than those in the control group,with statistical significance(P<0.05).Conclusion:The use of nalbuphine combined with propofol in the treatment of femoral neck fractures not only inhibits postoperative pain and the release of inflammatory factors in patients,but also reduces the amount of medication used and the incidence of agitation during the awakening period.
作者
孙倩
雷雯琪
李晴
SUN Qian;LEI Wenqi;LI Qing(Lankao Central Hospital,Kaifeng 475300,China)
出处
《临床医药实践》
2026年第2期109-114,共6页
Proceeding of Clinical Medicine
关键词
股骨颈骨折手术
纳布啡
丙泊酚
苏醒期躁动
血清炎症因子水平
femoral neck fracture surgery
nalbuphine
propofol
agitation during the awakening period
serum inflammatory factor level
