右美托咪定用于心血管术后患者镇静中的效果分析

Analysis of the Effect of Dexmedetomidine on Sedation of Patients after Cardiovascular Surgery

目的观察与评价右美托咪定用于心血管术后患者镇静中的效果。方法对该院2018年10月—2019年11月接受手术治疗的心血管疾病患者80例,分为试验组(右美托咪定镇静处理)对照组(丙泊酚镇静处理)各40例,观察与比较两组患者镇静评分、基本生命体征、术后疼痛评分、术后不良反应。结果实验组心率、舒张压、收缩压、脉平均动脉压均呈现不同程度的下降,两组各项指标,术后4 h、48 h分别为:(74.62±1.71)次/min、(77.08±2.72)次/min,(70.26±3.09)mmHg、(73.58±3.27)mmHg,(105.26±7.04)mmHg、(115.62±5.82)mmHg,(108.62±8.64)mmHg、(107.85±8.39)mmHg优于对照的(80.69±1.73)次/分、(83.03±2.67)次/分,(72.59±3.15)mmHg、(76.29±3.08)mmHg,(106.43±6.98)mmHg、(117.51±5.74)mmHg,(118.08±8.51)mmHg、(116.42±8.27)mmHg,差异有统计学意义(t=3.608、3.694、3.623、3.759、3.648、3.709、3.775、3.811,P<0.05),试验组血压波动相对更加稳定。试验组术后4 h、48 h Ramsay评分(2.32±0.35)分、(2.58±0.28)分与VAS评分(1.23±0.19)分、(1.96±0.19)分优于对照组(2.01±0.29)分、(2.12±0.31)分,(1.62±0.21)分、(2.34±0.17)分,差异有统计学意义(t=3.751、3.642、3.615、3.634,P<0.05)。试验组术后镇静期间不良反应发生率2.5%低于对照组12.5%,差异有统计学意义(χ^2=5.016,P<0.05)。结论与丙泊酚相比,对心血管手术患者术后采用右美托咪定镇静、镇痛效果良好,对患者人体血流动力学影响较小,不良反应更少。

Objective To observe and evaluate the effect of dexmedetomidine for sedation of patients after cardiovascular surgery.Methods Eighty patients with cardiovascular disease who underwent surgical treatment from October 2018 to November 2019 in the hospital were divided into experimental group(dexmedetomidine sedation treatment)and control group(propofol sedation treatment),40 cases each.Observe and compare the sedation score,basic vital signs,postoperative pain score,and postoperative adverse reactions of the two groups of patients.Results The heart rate,diastolic blood pressure,systolic blood pressure,and mean arterial blood pressure of the experimental group all showed varying degrees of decline.The indicators of the two groups at 4 and 48 hours after surgery were:(74.62±1.71)time/min,(77.08±2.72)time/min,(70.26±3.09)mmHg,(73.58±3.27)mmHg,(105.26±7.04)mmHg,(115.62±5.82)mmHg,(108.62±8.64)mmHg,(107.85±8.39)mmHg better than the control(80.69±1.73)time/min,(83.03±2.67)time/min,(72.59±3.15)mmHg,(76.29±3.08)mmHg,(106.43±6.98)mmHg,(117.51±5.74)mmHg,(118.08±8.51)mmHg,(116.42±8.27)mmHg,the difference was statistically significant(t=3.608,3.694,3.623,3.759,3.648,3.709,3.775,3.811,P<0.05),the blood pressure fluctuation in the experimental group was relatively more stable.The Ramsay score(2.32±0.35)points,(2.58±0.28)points and VAS scores(1.23±0.19)points and(1.96±0.19)points of the test group were better than the control group(2.01±0.29)points after 4 and 48 hours of operation,(2.12±0.31)points,(1.62±0.21)points,(2.34±0.17)points,the difference was statistically significant(t=3.751,3.642,3.615,3.634,P<0.05).The incidence of adverse reactions in the experimental group during postoperative sedation was 2.5%lower than that in the control group 12.5%,the difference was statistically significant(χ^2=5.016,P<0.05).Conclusion Compared with propofol,dexmedetomidine has a good sedative and analgesic effect on postoperative patients undergoing cardiovascular surgery.It has less impact on the hemodynamics and fewer adverse reactions in patients.