舒芬太尼联合右美托咪定在髌骨骨折患者经皮穿刺张力带固定术中麻醉的应用及对患者苏醒质量的影响

Application of sufentanil combined with dexmedetomidine in anesthesia for patients with patellar fracture undergoing percutaneous tension band fixation and its effect on the quality of recovery

目的探讨舒芬太尼联合右美托咪定在髌骨骨折患者经皮穿刺张力带固定手术中麻醉的应用及对患者苏醒质量的影响。方法选取该院2016年1月至2017年1月收治的髌骨骨折患者共120例作为研究对象,按照随机数字表法分为对照组(n=60)和研究组(n=60),对照组给予舒芬太尼治疗,研究组在对照组基础上给予右美托咪定治疗,比较两组患者治疗后的临床效果、视觉模拟评分(VAS评分)、不良反应发生情况、镇静评分(Ramsay评分)及血流动力学情况。结果治疗后研究组患者治疗有效率明显高于对照组,差异有统计学意义(P<0.05);研究组患者治疗后8h镇痛评分明显低于对照组,差异有统计学意义(P<0.05);研究组患者不良反应发生率明显低于对照组,差异有统计学意义(P<0.05);研究组患者治疗24h后镇静效果明显优于对照组,差异有统计学意义(P<0.05);研究组患者红细胞聚集指数、全血高切黏度、全血低切黏度、纤维蛋白原水平均低于对照组,差异均有统计学意义(P<0.05)。结论舒芬太尼联合右美托咪定在髌骨骨折患者经皮穿刺张力带固定手术中麻醉应用效果明显,对患者苏醒质量有积极影响,临床价值突出,值得在临床进一步推广应用。

Objective To investigate the application of sufentanil combined with dexmedetomidine in percutaneous tension band fixation for patellar fracture and its effect on the recovery quality of patients.Methods A total of120patients with patellar fracture admitted to our hospital from January2016to January2017were selected as the research object.They were randomly divided into control group(n=60)and research group(n=60)according to the digital table method.The control group was treated with sufentanil,and the research group was treated with dexmedetomidine on the basis of the control group.The clinical effect,VAS score,incidence of adverse reactions,sedation score(Ramsay score)and hemodynamics of the patients after treatment.Results After treatment,the effective rate of treatment in the study group was significantly higher than that in the control group(P<0.05).The analgesic score in the study group was significantly lower than that in the control group(P<0.05).The incidence of adverse reactions in the study group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).The sedative effect of the study group was significantly better than that of the control group after24hours of treatment(P<0.05).The erythrocyte aggregation index,whole blood high shear viscosity,whole blood low shear viscosity and fibrinogen of the study group were lower than those of the control group,with a statistical significance(P<0.05).Conclusion Sufentanil combined with dexmedetomidine has a significant clinical effect in the application of anesthesia during the percutaneous tension band fixation for patellar fracture patients.It has a positive effect on the quality of recovery of patients and the clinical value is outstanding.It is worthy of further clinical application.