【摘要】：目的:觀察右美托咪定復(fù)合舒芬太尼術(shù)后靜脈鎮(zhèn)痛對腹腔鏡胃切除患者術(shù)后腸功能的影響。方法:擇期行腹腔鏡胃切除患者60例,術(shù)后使用靜脈自控鎮(zhèn)痛,隨機(jī)分為兩組:右美托咪定組(S組)和右美托咪定復(fù)合舒芬太尼組(SD組)。記錄兩組患者術(shù)后第1次腸排氣時(shí)間、腸功能指數(shù)(bowel function index,BFI)、術(shù)后靜息和咳嗽時(shí)疼痛數(shù)字評分(numerical rating scales,NRS)、首次使用哌替啶的時(shí)間和術(shù)后48 h內(nèi)哌替啶總量、術(shù)后不良反應(yīng)(呼吸抑制、惡心、嘔吐)。結(jié)果:SD組患者術(shù)后第1次腸排氣時(shí)間為術(shù)后(67.2±3.5)h,與S組(73.1±5.3)h相比,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);SD組與S組術(shù)后BFI≤28.8的患者分別為26例(86.7%)和19例(63.3%)(P0.05);SD組患者術(shù)8、16、24、36、48 h靜息NRS和術(shù)后4、8、16、24、36、48 h咳嗽NRS均顯著低于S組(P0.05)。SD組患者術(shù)后首次使用哌替啶時(shí)間為(8.2±2.4)h,與S組(4.3±1.9)h相比,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);SD組與S組哌替啶使用量分別為(70.5±21.9)mg和(105.4±32.2)mg,兩組比較,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);術(shù)后惡心發(fā)生率SD組和S組分別為4例(13.3%)和11例(36.7%),差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:右美托咪定復(fù)合舒芬太尼術(shù)后鎮(zhèn)痛能有效減輕腹腔鏡胃切除患者術(shù)后疼痛,減少哌替啶的用量,促進(jìn)患者術(shù)后腸功能恢復(fù)。
[Abstract]:Objective: to observe the effect of intravenous analgesia with dexmetiomide combined with sufentanil on intestinal function in patients with laparoscopic gastroresection. Methods: sixty patients undergoing laparoscopic gastroresection were randomly divided into two groups: right metomipramine group (S group) and right metomide combined with sufentanil group (SD group). The first intestinal exhaust time, intestinal function index (bowel function index,BFI), postoperative rest and cough pain score (numerical rating scales,NRS), the time of first use of pethidine and the total amount of pethidine within 48 hours after operation were recorded. Postoperative adverse reactions (respiratory suppression, nausea, vomiting). Results: the first intestinal exhaust time in SD group was (67.2 鹵3.5) h, which was significantly different from that in S group (73.1 鹵5.3) h (P 0.05). There were 26 patients (86.7%) and 19 patients (63.3%) with BFI 鈮，

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