右美托咪定对全麻苏醒期患者躁动及围手术期医院感染的影响

Effect of dexmedetomidine on restlessness and perioperative nosocomial infections in patients with general anesthesia

目的分析右美托咪定对全麻苏醒期患者躁动及围手术期医院感染的影响。方法选取2013年2月-2016年5月期间于医院接受治疗的120例脑膜瘤切除术患者,随机分为试验组与对照组,每组各60例;观察分析两组在术前与苏醒期的心率(HR)、收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)及脉搏血氧饱和度(SpO2)指标水平,视觉模拟评分法(VAS)评分,手术前后的肿瘤坏死因子-α(TNF-α)及白细胞介素-8(IL-8)水平及并发症情况。结果两组术前与苏醒期的HR、MAP、SpO2、SBP、DBP指标水平有差异(P<0.05),且试验组苏醒期的HR、MAP、SpO2指标均高于对照组(P<0.05);全麻苏醒期,试验组躁动发生率11.67%低于对照组的31.67%(P<0.05);术后试验组的TNF-α、CRP与IL-8水平低于对照组(P<0.05);术后,试验组患者总不良反应发生率率为8.33%,低于对照组的23.33%(P<0.05)。结论右美托咪定可以降低全麻苏醒期患者的躁动率及改善脉搏指标水平,同时可以降低围手术期患者的医院感染率,并改善预后,有助于患者的身心健康。

OBJECTIVE To analyze the effects of dexmedetomidine on restlessness and perioperative nosocomial infections in patients with general anesthesia.METHODS A total of 120 cases of meningiectomy patients from Feb.2013 to May 2016 treated in the hospital were selected,and were randomly divided into observation group and control group,with 60 cases in each group.Heart rate（HR）,systolic blood pressure（SBP）,diastolic blood pressure（DBP）,mean arterial pressure（MAP）,mean arterial pressure（MAP）,oxygen saturation（SpO2）,visual analogue scale（VAS）,tumor necrosis factor-α（TNF-α）,interleukin-8（IL-8）levels and complications of the two groups were measured before and after treatment.RESULTS There were significant differences in the levels of HR,MAP,SpO2,SBP and DBP before the operation between the two groups（P〈0.05）,and the indexes of HR,MAP and SpO2 in the recovery stage in observation group were significently higher than those in control group（P〈0.05）.In the general anesthesia recovery period,the incidence of restlessness in observation group was11.67%,which was significantly lower than 31.67% of control group（P〈0.05）.After treatment,the levels of TNF-α,CRP and IL-8 in observation group were significantly lower than those in control group（P〈0.05）.After treatment,the total incidence of adverse reactions in observation group was 8.33%,which was significantly lower than 23.33%in control group（P〈0.05）.CONCLUSIONDexmedetomidine can reduce the restlessness in patients of general anesthesia recovery period and improve the pulse level,and can reduce the perioperative nosocomial infection rate and improve the prognosis,which contributes to the patient＇s physical and mental health.