纳美芬联合盐酸羟考酮对上腹部手术患者麻醉苏醒期躁动的影响.doc

精品论文 参考文献 纳美芬联合盐酸羟考酮对上腹部手术患者麻醉苏醒期躁动的影响 程伟 殷琴 张联义 齐敦益 颜明 刘金东 闫长栋 　　（徐州医学院附属医院lt;徐州医学院gt; 221002） 　　【摘要】 目的：探讨纳美芬联合盐酸羟考酮对上腹部手术患者麻醉苏醒期躁动的影响。方法：上腹部手术患者随机分为盐酸羟考酮组（A组），纳美芬联合盐酸羟考酮组（B组），术后用PCA镇痛，记录麻醉诱导前、术后1、6、12、24、48h的HR、SPO2、SBP/DBP、躁动发生率、Ramsay评分及疼痛视觉模拟评分(VAS)情况。结果：B组患者Ramsay评分较A组高(Plt;0.05)、躁动发生率、恶心呕吐发生率、和VAS评分和较A组低(Plt;0.05)。结论：纳美芬联合盐酸羟考酮用于上腹部手术后镇痛可减少麻醉苏醒期躁动发生率，减少胃肠道不良反应发生。 　　【关键词】纳美芬；盐酸羟考酮 　　【中图分类号】R453 【文献标识码】A 【文章编号】2095-1752（2015）30-0124-02 　　Effect of nalmefene combined oxycodone hydrochloride on patients undergoing upper abdominal operation 　　Cheng Wei ,Yin Qin,Zhang Lianyi,Qi Dunyi,Yan Ming,Liu Jindong,Yan Changdong. 　　Affiliated Hospital of Xuzhou Medical College (Xuzhou Medical College) 221002 　　【Abstract】 Objective To investigate the effects of oxycodone hydrochloride and nalmefene on emergence agitation and Hemodynamics of patients undergoing upper abdominal operation. Methods ASA gradeⅠ-Ⅱ patients undergoing elective upper abdominal operation were randomly divided into two groups: oxycodone hydrochloride group (group A), nalmefene and oxycodone hydrochloride group (group B) with 30 patients in each group, after the operation, the incidence of agitation, SBP/DBP, HR, SPO2,VAS score and Ramsay sedation score were recorded at the following time points: before induction of anesthesia, 1, 6, 12, 24, 48 hours after operation. Results Compared with group B, Ramsay sedation scores of patients in group A were slightly lower (Plt;0.05); the incidence and degree of agitation in B group were lower than A group (Plt;0.01). Conclusion Oxycodone hydrochloride combined with nalmefene can make patients quiet cooperation and reduce emergence agitation during recovery period after upper abdominal operation. 　　【Keywords】 Nalmefene; Oxycodone hydrochloride 　　上腹部开放手术在麻醉苏醒期患者出现血压升高、心动过速、烦躁、谵妄及不同程度的意识障碍等生命体征不稳定情况，给患者生命安全和术后恢复带来不良影响。本研究拟探讨纳美芬联合盐酸羟考酮用于上腹部手术患者术后镇痛的效果和不良反应情况，探索上腹部开放手术患者麻醉苏醒期躁动处理的新方法。 　　1.资料与方法 　　1.1 资料 　　选择全麻下行择期上腹部开放手