布托啡诺对自发性脑出血术后患者胃肠功能的影响

Effect of butorphanol on gastrointestinal function in patients with spontaneous intracerebral hemorrhage after operation

目的观察应用布托菲诺对自发性脑出血术后患者胃肠功能的影响,为临床镇痛镇静的治疗提供依据。方法选择2021-07—2022-07周口市中心医院神经重症监护室收治的脑出血行开颅手术治疗的患者60例,随机分为2组,每组30例。布托菲诺组患者给予布托啡诺联合右美托咪定镇痛镇静,舒芬太尼组患者给予舒芬太尼联合右美托咪定治疗。监测2组术后不同时间点的腹内压水平,并搜集2组相关临床指标进行比较。结果布托菲诺组在用药后48 h的腹内压水平均显著低于舒芬太尼组[(11.62±2.81)vs(13.34±3.12)mmHg(1 mmHg=0.133kPa)]vs 72 h[(7.88±1.42)vs(12.78±2.69)mmHg],差异有统计学意义(P<0.05)。布托菲诺组患者首次排便时间[(55.97±7.64)h vs(89.60±17.64)h]、恶心及呕吐发生率(13.3%vs 43.3%)均显著低于舒芬太尼组,差异有统计学意义(P<0.05)。布托菲诺组肠内营养耐受情况则优于舒芬太尼组(76.7%vs 50%),差异有统计学意义(P<0.05),余差异无统计学意义。结论相比较于舒芬太尼,布托菲诺对自发性脑出血术后患者的胃肠功能影响较小。

Objective To explore the effects of butorphanol on gastrointestinal function in patients with spontaneous intracerebral hemorrhage after operation,and provide evidence for clinical analgesic and sedative treatment.Methods Sixty Patients with spontaneous intracerebral hemorrhage after operation admitted to the NSICU between July 2021 and July 2022 were included and divided into two groups randomly,the Butorphanol group(30cases)and the Sufentanil group(30 cases).Patients in the Butorphanol group were treated with Butorphanol plus Dexmedetomidine and those in the Sufentanil group were treated with Sufentanil plus Dexmedetomidine for analgesia and sedation.The clinical indices and IAP level at different time points were collected and compared between the two groups.Results The IAP level in the Butorphanol group was significantly lower than that in the Sufentanil group at 48 h[(11.62±2.81)vs(13.34±3.12)mmHg(1 mmHg=0.133 kPa)]and 72 h[(7.88±1.42)vs(12.78±2.69)mmHg]after treatment(P<0.05).The patients of the butorphanol group had shorter time of first defecation[(55.97±7.64)h vs(89.60±17.64)h]and lower incidence rates of postoperative nausea and vomiting(13.3%vs 43.3%)(both P<0.05).While the patients of the butorphanol group had better tolerance rate of enteral nutrition(P<0.05).The rest were not statistically significant.Conclusion Compared with Sufentanil,butorphanol may have less harmful effect on gastrointestinal function in patients with spontaneous intracerebral hemorrhage after operation.