| 许晶晶,陈耀,田环环,等.围术期输注右美托咪定对剖宫产病人术后恢复质量的影响[J].安徽医药,2021,25(11):2312-2316. |
| 围术期输注右美托咪定对剖宫产病人术后恢复质量的影响 |
| Effect of perioperative infusion of dexmedetomidine on postoperative quality of recovery QoR-40 in patients undergoing cesarean section |
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| DOI：10.3969/j.issn.1009-6469.2021.11.046 |
| 中文关键词: 右美托咪定 康复 剖宫产术 手术后并发症 术后恢复 |
| 英文关键词: Dexmedetomidine Rehabilitation Cesarean section Postoperative complications Postoperative recovery |
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| 中文摘要: |
| 目的探讨围术期输注右美托咪定( Dex)对剖宫产病人术后恢复质量( QoR-40)的影响。方法选取 2019年 6月至 2019年 11月徐州医科大学附属医院择期腰硬联合麻醉下行剖宫产手术的病人 64例，按随机数字表法分为观察组和对照组，每组 32例。在胎儿娩出断脐后，观察组病人予 Dex 0.5 μg/kg泵注 10min，随后以 0.5 μg·kg-1·h-1泵注至手术缝皮结束，对照组给予静脉输注同等体积的生理盐水，术后均行 PCIA自控镇痛(均加生理盐水配置至总容量 100 mL)，观察组: Dex 2 μg/kg+舒芬太尼 1.5 μg/kg+托烷司琼 6 mg，对照组:舒芬太尼 1.5 μg/kg+托烷司琼 6 mg。记录产妇术后 d1、d3、d5的 QoR-40得分、 FS-14疲劳评分及相关不良反应。结果与对照组比较，观察组产妇术后 d3的 QoR-40评分显著升高［(174.1±11.6)分比( 179.9±7.1)分， P<0.05］术后 d1、d3、d5的 FS-14疲劳评分显著降低( P<0.05)。观察组产妇在术后 d1的疼痛感受评分上及在术后 d3的情绪评分及疼痛，感受评分上明显高于对照组( P<0.05)而两组产妇在术后不同时间点的身体舒适度、身体独立能力及病人支持评分方面差异无统计学意义( P>0.05)。与对照组比较，，观察组产妇在术后寒颤及恶心、呕吐不良反应发生率明显降低( P<0.05)，两组新生儿术后不良反应发生率差异无统计学意义( P>0.05)。结论围术期输注 Dex可以提高剖宫产病人术后 d3的 QoR-40得分，改善产妇的术后疲劳，降低术后不良反应发生率，从而提高产妇术后恢复质量。 |
| 英文摘要: |
| Objective To study the effect of perioperative infusion of dexmedetomidine (Dex) on the postoperative quality of recovery QoR-40 in patients undergoing cesarean section.Methods Sixty-four patients undergoing selective cesarean section under combined spinal-epidural anaesthesia in Affiliated Hospital of Xuzhou Medical University from June 2019 to November 2019 were selectedand randomly divided into the group D and the group C, with 32 cases in each group. After delivery and cord clamping, 0.5 μg/kg Dexwas pumped for 10 minutes in group D, followed by 0.5 μg·kg-1·h-1 to the end of surgical suture skin. Group C was given intravenous infusion of the same volume of normal saline. All patients received patient-controlled analgesia with PCIA after operation (all patientswere allocated to total volume 100 mL). Group D: Dex 2 μg/kg + sufentanil 1.5 μg/kg + tropisetron 6 mg, Group C: sufentanil 1.5 μg/kg+ tropisetron 6 mg. The QoR-40 score, FS-14 fatigue score and related adverse reactions were recorded on the 1st, 3rd and 5th day after operation.Results Compared with group C, the QoR-40 score of group D was significantly higher on the 3rd day after operation [(174.1±11.6) vs. (179.9±7.1)], and the FS-14 fatigue score on the 1st, 3rd and 5th day after operation was significantly lower than that of group C (P<0.05). In group D, the pain perception score on the 1st postoperative day and the emotional score and pain perceptionscore on the 3rd day after operation were significantly higher than those in the group C (P<0.05). There was no significant difference inphysical comfort, physical independence and patient support scores between the two groups at different time after operation (P>0.05). Compared with group C, the incidence of postoperative shivering, nausea and vomiting in group D was significantly lower (P<0.05), butthere was no significant difference in the incidence of postoperative adverse reactions between the two groups of neonates (P>0.05). Conclusion Perioperative infusion of Dex can improve the QoR-40 score of patients on the 3rd day after cesarean section, improvepostoperative fatigue, reduce the incidence of postoperative adverse reactions, and improve the quality of postoperative recovery. |
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