【摘要】：目的:探討右美托咪定聯(lián)合噴他佐辛對(duì)老年患者全髖關(guān)節(jié)置換術(shù)后的鎮(zhèn)痛效果及其對(duì)炎癥因子、纖維蛋白原(Fib)和D-二聚體水平的影響。方法:選取96例符合納入標(biāo)準(zhǔn)的老年全髖關(guān)節(jié)置換術(shù)患者作為觀察對(duì)象,按照隨機(jī)數(shù)字表法分為對(duì)照組和觀察組,各48例。對(duì)照組給予噴他佐辛鎮(zhèn)痛治療,觀察組在對(duì)照組的基礎(chǔ)上給予右美托咪定鎮(zhèn)痛。術(shù)后采用視覺(jué)模擬評(píng)分(VAS)法評(píng)價(jià)疼痛程度。分別比較兩組患者術(shù)后6、12、24 h時(shí)的VAS。術(shù)后24 h比較兩組患者血清腫瘤壞死因子α(TNF-α)、白細(xì)胞介素6(IL-6)、白細(xì)胞介素8(IL-8)等炎癥因子水平及Fib、D-二聚體水平,并比較兩組不良反應(yīng)發(fā)生情況。結(jié)果:與對(duì)照組相比,觀察組患者術(shù)后6、12、24 h時(shí)VAS降低[分別為(2.35±0.94)vs.(3.96±1.05)分,(1.66±0.71)vs.(2.87±0.82)分,(1.32±0.52)vs.(2.15±0.63)分],差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。術(shù)后24 h與對(duì)照組比較,觀察組血清TNF-α、IL-6、IL-8等炎癥因子水平降低[分別為(2.02±0.67)vs.(3.95±0.96)pg·ml~(-1),(32.24±4.76)vs.(40.16±5.25)pg·ml~(-1),(20.37±4.26)vs.(30.29±5.71)pg·ml~(-1)],Fib、D-二聚體水平也降低[分別為(3.9±0.3)vs.(4.2±0.4)g·L~(-1),(224.7±18.5)vs.(251.3±20.2)ng·ml~(-1)],兩組間比較差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。術(shù)后對(duì)照組和觀察組不良反應(yīng)發(fā)生率分別為8.3%和14.6%,兩組間比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),所有患者均未出現(xiàn)嚴(yán)重不良反應(yīng)。結(jié)論:右美托咪定聯(lián)合噴他佐辛在老年患者全髖關(guān)節(jié)置換術(shù)后鎮(zhèn)痛中應(yīng)用效果良好,能夠有效減輕術(shù)后疼痛及炎癥反應(yīng),改善血液高凝狀態(tài),且不良反應(yīng)輕微。
[Abstract]:Aim: to investigate the analgesic effect of dexmetomidine combined with pentazol on the levels of inflammatory factors, fibrinogen (Fib) and D-dimer in elderly patients after total hip replacement. Methods: 96 elderly patients with total hip replacement were selected and divided into control group and observation group according to random digital table. The control group was treated with pantazosine analgesia, and the observation group was treated with dexmetomidine on the basis of the control group. Postoperative pain was evaluated by visual analogue score (VAS). Comparison of VAS. between the two groups at 612h after operation Serum levels of tumor necrosis factor 偽 (TNF- 偽), interleukin-6 (IL-6), interleukin-8 (IL-8) and Fib,D- dimer were compared 24 hours after operation between the two groups. Results: compared with the control group, the VAS of the observation group was significantly lower than that of the control group at 612h (2.35 鹵0.94) vs. (3.96 鹵1.05), (1.66 鹵0.71) vs. (2.87 鹵0.82) and (1.32 鹵0.52) vs. (2.15 鹵0.63), respectively (P0.05). 鏈悗24 h涓庡鐓х粍姣旇緝,瑙傚療緇勮娓匱NF-偽,IL-6,IL-8絳夌値鐥囧洜瀛愭按騫抽檷浣嶽鍒嗗埆涓，

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