保温联合右美托咪定对前列腺电切患者术后早期恢复的影响

Effect of insulation combined with dexmedetomidine on early postoperative recovery of patients undergoing prostate resection

目的观察保温联合右美托咪定(DEX)对前列腺电切(TURP)患者早期恢复的影响。方法选取2022年5月至10月中国医科大学附属盛京医院泌尿外科收治的全身麻醉下行TURP的患者96例,随机分为加温组(T组)和加温联合DEX组(TD组)。比较2组体温、平均动脉压(MAP)、心率(HR)变化,术后寒战、心动过缓、苏醒延迟发生情况,以及术后疼痛(VAS)、镇静、睡眠(AIS)、恢复质量(QoR-15)和焦虑(HADS)评分。结果与T组同时间点比较,TD组患者体温无统计学差异;术后30 min HR降低;持续冲洗30 min和手术结束时间点MAP降低;TD组寒战发生率降低(均P<0.05)。与T组比较,TD组镇静评分、术后1 d QoR-15评分升高,AIS评分降低,有统计学差异(P<0.05);而VAS评分,术后1 d HADS评分,术后3 d AIS,QoR-15和HADS评分无统计学差异。结论保温联合DEX有利于TURP患者的早期恢复。

Objective To observe the effect of body temperature protection combined with dexmedetomidine(DEX)on the early recovery of patients with electroprostate resection.Methods A total of 96 elderly patients who underwent electroprostate resection under general anesthesia at Shengjing Hospital,China Medical University,were divided into a warming group(group T)and a warming combined with dexmedetomidine group(group TD).The changes in body temperature,mean arterial pressure(MAP),heart rate(HR),postoperative chills,bradycardia,and delayed awakening were compared between groups at different time points.Additionally,the postoperative pain(visual analog scale,VAS),sedation(Ramsay),sleep quality(Athens Insomnia Scale,AIS),recovery quality(Quality of Recovery-15,QoR-15),and anxiety scores(Hospital Anxiety and Depression Scale,HADS)were compared.Results No significant intergroup changes in body temperature were noted.HR was significantly reduced 30 min after surgery,as was MAP 30 min after bladder irrigation and at the end of surgery.The incidence of chills was significantly reduced in group TD(P<0.05).The mean Ramsay score and QoR-15 score at 1 day postoperative were significantly increased in group TD,while the mean AIS score at 1 day postoperative was significantly reduced(P<0.05).The mean VAS score after extubation;HADS score at 1 day postoperative;and AIS,QoR-15,and HADS scores at 3 days postoperative did not differ significantly between groups.Conclusion Body temperature protection combined with DEX can benefit the early recovery of elderly patients after electro-resection of the prostate.