右美托咪定联合舒芬太尼对体外循环心脏瓣膜置换术患者围术期器官保护及术后认知功能的影响

Effects of Dexmedetomidine Combined with Sufentanil on Perioperative Organ Protection and Postoperative Cognitive Function in Patients Undergoing Cardiopulmonary Bypass Cardiac Valve Replacement

目的 研究右美托咪定联合舒芬太尼对体外循环(CPB)心脏瓣膜置换术患者围术期器官保护及术后认知功能的影响。方法 选取2019年5月-2021年5月于我院行CPB下心脏瓣膜置换术治疗的80例患者为研究对象,随机分为对照组与观察组,各40例。对照组全程采用舒芬太尼镇痛,观察组则采用右美托咪定联合舒芬太尼镇痛,比较两组术后VAS疼痛评分、围术期麻醉药物使用量、围术期器官保护作用及术后认知功能。结果 观察组术后1、3 d VAS评分低于对照组,差异有统计学意义(P<0.05);观察组围术期麻醉药物使用量小于对照组,差异有统计学意义(P<0.05);术后1 d,两组肝脏、肾脏、心脏损伤指标均有升高,但观察组低于对照组,差异有统计学意义(P<0.05);观察组术后MMSE、MoCA评分高于对照组,差异有统计学意义(P<0.05)。结论 右美托咪定联合舒芬太尼可提升CPB心脏瓣膜置换术患者的术后镇痛效果,减少麻醉药物用量,对患者心、肝、肾器官具有较好保护作用,有利于减轻术后认知功能损害。

Objective To study the effects of dexmedetomidine combined with sufentanil on perioperative organ protection and postoperative cognitive function in patients undergoing cardiopulmonary bypass(CPB) cardiac valve replacement.Methods A total of 80 patients who underwent CPBcardiac valve replacement in our hospital from May 2019 to May 2021 were randomly divided into control group and observation group,with 40 cases in each group.The control group was treated with sufentanil for analgesia,while the observation group was treated with dexmedetomidine combined with sufentanil for analgesia.The postoperative VAS pain score,perioperative anesthetic dosage,perioperative organ protection and postoperative cognitive function were compared between the two groups.Results The VAS score of the observation group was lower than that of the control group at 1 and 3 days after operation,and the difference was statistically significant(P<0.05).The amount of anesthetics used in the observation group was less than that in the control group,and the difference was statistically significant(P <0.05).One day after operation,the indexes of liver,kidney and heart injury in the two groups increased,but those in the observation group were lower than the control group,and the differences were statistically significant(P <0.05).The MMSE and MoCA scores of the observation group were higher than those of the control group,and the difference was statistically significant(P <0.05).Conclusion Dexmedetomidine combined with sufentanil can improve the postoperative analgesic effect of patients undergoing CPBcardiac valve replacement,reduce the dosage of anesthetic drugs,and have a good protective effect on the heart,liver and kidney organs,which is conducive to reducing postoperative cognitive impairment.