右美托咪定联合舒芬太尼对脊柱外科患者镇痛效果、免疫功能及凝血功能的影响

Effect of dexmedetomidine combined with sufentanil on analgesic effect, immune function and coagulation function in patients undergoing spine surgery

目的研究右美托咪定联合舒芬太尼对脊柱外科患者的镇痛效果及其对患者免疫功能及凝血功能的影响。方法回顾性分析本院骨科及脊柱外科行手术治疗的患者 60 例,按照治疗方式分为对照组与观察组,每组各 30 例。比较 2 组患者手术结束后 8 h、24 h、48 h 时 VAS 疼痛评分及Ramsay 镇静评分;分别于术前、术后 8 h 及术后 24 h 检测2 组患者血清中 T 淋巴细胞亚群水平、活化部分凝血活酶时间( APTT)、凝血酶原时间( PT)及凝血酶时间( TT)。结果术后 24 h 及术后 48 h,2 组患者 VAS 评分均较本组术后 8 h 升高,且观察组 VAS 评分明显低于对照组,差异有统计学意义( P < 0. 05)。术后各时间点 2 组患者Ramsay 评分比较,差异均无统计学意义( P > 0. 05)。术后 8 h 及术后24 h,2 组患者 CD3^+、CD4^+、CD4^+/CD8 +比值、APTT、PT 及 TT 水平均较本组术前显著降低,且观察组 CD3^+、CD4^+及 CD4 +/CD8^+比值明显高于对照组,APTT、PT 及 TT 水平明显低于对照组,差异有统计学意义( P < 0. 05)。术后 24 h, 2 组患者 CD3^+、CD4^+及 CD4^+/CD8 +比值与本组术后 8 h 比较,均明显升高,差异有统计学意义( P < 0. 05)。结论右美托咪定联合舒芬太尼术后镇痛可缓解脊柱外科患者术后疼痛,改善患者免疫功能及凝血功能,利于患者术后恢复。

Objective To study the analgesic effect of dexmedetomidine combined with sufentanil on patients with spinal surgery and its effect on immune function and coagulation function. Methods Retrospective analysis was performed on 60 patients undergoing spinal surgery in Department of Orthopedics and Department of Spinal Surgery. They were divided into control group and observation group according to the method of treatment,with 30 cases in each group. At 8 h,24 h and 48 h after operation, VAS pain score and Ramsay sedation score were compared between the 2 groups. The levels of T lymphocyte subsets,activated partial thromboplastin time ( APTT),prothrombin time ( PT) and thrombin time ( TT) were detected in the 2 groups before operation,and at 8 h,24 h after the operation. Results At 24 h and 48 h after operation,the VAS scores of the two groups were higher than that of the group at 8 h after operation,and the VAS scores of observation group were significantly lower than that of the control group,and the difference was statistically significant ( P < 0. 05). There was no statistical significance on the difference in Ramsay score between the two groups at different time after operation ( P > 0. 05). At 8 h and 24 h after operation, the levels of CD3^+,CD4^+,CD4^+/CD8^+,APTT,PT and TT in the two groups were significantly lower than those before operation,and the levels of CD3^+,CD4^+ and CD4^+/CD8 + of the observation group were significantly higher than those of the control group,and the levels of APTT,PT and TT were significantly lower than those of the control group ( P < 0. 05). At 24 h after operation,the levels of CD3^+,CD4^+ and CD4^+/CD8^+ in the two groups were significantly higher than those in the groups at 8 h after operation,and the differences were statistically significant ( P < 0. 05). Conclusion Dexmedetomidine combined with sufentanil can relieve postoperative pain of patients after spinal surgery. It can improve the immune function and coagulation function of the patients,and help the patients recover after operation.