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盐酸羟考酮注射液联合右美托咪定对腹腔镜胆囊切除术患者血栓素A2和血浆内皮素及镇痛效果的影响
王明虹,朱艺霞,谢薇薇,黄瑾娴,罗丁梅
0
(福建医科大学附属宁德市医院麻醉科)
摘要:
【摘要】目的 探讨盐酸羟考酮注射液联合右美托咪定在腹腔镜胆囊切除术中的应用及对血栓素A2、血浆内皮素及镇痛效果的影响。方法 选择2017年4月~2019年4月福建医科大学附属宁德市医院收治的腹腔镜胆囊切除患者90例进行研究,以随机数表法分为联合组(n=35)、羟考酮组(n=30)和右美托咪定组(n=25)。右美托咪定组给予右美托咪定,羟考酮组给予盐酸羟考酮、联合组采用羟考酮注射液联合右美托咪定。比较3组苏醒时间、拔管时间、肛门排气时间;麻醉诱导前(T0)、插管后(T1)、气腹后(T2)、术中(T3)、术后拔管(T4)血栓素A2、血浆内皮素术后6、12、24及48 h疼痛评分变化情况及不良反应发生情况。结果 联合组苏醒时间、拔管时间及肛门排气时间均显著低于羟考酮组、右美托咪定组(P<005);在T0、T1时,3组血栓素A2、血浆内皮素水平比较差异无统计学意义(P>005);在T2、T3、T4时,3组血栓素A2、血浆内皮素水平均显著升高,且联合组低于羟考酮组、右美托咪定组(P<005);术后6、12、24及48 h时,联合组疼痛评分均显著低于羟考酮组、右美托咪定组(P<005);联合组不良反应总发生率显著低于羟考酮组、右美托咪定组(P<005)。结论 在腹腔镜胆囊切除术中应用盐酸羟考酮注射液联合右美托咪定效果显著,可有效改善血栓素A2、血浆内皮素水平及疼痛情况,且不会增加不良反应。
关键词:  盐酸羟考酮注射液  右美托咪定  腹腔镜胆囊切除术  血栓素A2  内皮素  镇痛效果
DOI:
基金项目:福建省医学创新课题(2016 CXB 5)
Application of oxycodone hydrochloride injection combined with dexmedetomidine in laparoscopic cholecystectomy and its effect on thrombin A2, plasma endothelin and analgesic effect
WANG Minghong,ZHU Yixia,XIE Weiwei,HUANG Jinxian,LUO Dingmei
(Department of Anesthesiology, Ningde Hospital, Fujian Medical University)
Abstract:
【Abstract】Objective To study Application of oxycodone hydrochloride injection combined with dexmedetomidine in laparoscopic cholecystectomy and its effect on thrombin A2, plasma endothelin and analgesic effect. Methods Ninety laparoscopic cholecystectomy patients admitted to our hospital from April 2017 to April 2019 were selected for the study, were randomly divided into the combined group (n=35), the oxycodone group (n=30) and the dexmedetomidine group (n=25). Dexmedetomidine group was given dexmedetomidine, oxycodone group was given oxycodone hydrochloride, and combination group was given oxycodone injection combined with dexmedetomidine. The waking time, extubation time, anal exhaust time, thrombin A2, plasma endothelin, pain score and adverse reactions were compared among the three groups. Results The recovery time, extubation time and anal exhaust time in the combined group were significantly lower than those in the oxycodone group and the dexmedetomidine group (P<005). At T0 and T1, there was no significant difference in thrombin A2 and plasma endothelin levels among the three groups. At T2, T3 and T4, the levels of thrombin A2 and plasma endothelin in all three groups were significantly increased, and the combined group was lower than the oxycodone group and the dexmedetomidine group, with significant differences (P<005). At 6h, 12h, 24h and 48h after surgery, pain scores of the combined group were significantly lower than those of the oxycodone group and the dexmedetomidine group, with significant differences (P<005). The total incidence of adverse reactions in the combined group was 1143%, significantly lower than 3000% and 4000% in the oxycodone group and dexmedetomidine group (P<005). Conclusion In laparoscopic cholecystectomy, oxycodone hydrochloride injection combined with dexmedetomidine has a significant effect, which can effectively improve the level of thrombin A2, plasma endothelin and pain without increasing adverse reactions.
Key words:  Oxycodone hydrochloride injection  Dexmedetomidine  Laparoscopic cholecystectomy  Thrombin A2  Endothelin  Analgesic effect

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