摘要
目的探讨右美托咪定联合长托宁用于经尿道前列腺切除术(TURP)的镇痛效果以及分析其对患者术后血清神经元特异性烯醇化酶(NSE)、髓鞘碱性蛋白(MBP)水平的影响。方法选取成都市第二人民医院2019年9月-2021年7月收治的拟行TURP的患者86例。按照随机数字表法分为联用组(n=43,右美托咪定联合长托宁镇痛)和对照组(n=43,长托宁镇痛)。对比分析两组患者术后各时间段的疼痛视觉模拟评分(VAS)、膀胱痉挛的次数及术后另外使用镇痛药的例数。比较患者术前1 d及术后1、3、7 d的认知状态和NSE、MBP水平。结果联用组患者在术后4、8、12、24 h各时间段VAS评分、膀胱痉挛次数及术后第1天使用镇痛药比率均低于对照组,差异均具有统计学意义(P<0.05)。在术后1、3、7 d,联用组患者的简易精神状态量表(MMSE)评分均高于对照组(P<0.05),血清NSE水平及MBP水平均低于对照组(P<0.05)。结论对行TURP患者在术前及术中应用右美托咪定联合长托宁可取得较好的镇痛效果,可通过减轻患者的脑细胞损害改善术后认知障碍。
Objective To explore the analgesic effect of dexmedetomidine combined with penehyclidine hydrochloride in transurethral resection of prostate(TURP)and to analyze its effects on the levels of postoperative serum neuron-specific enolase(NSE)and myelin basic protein(MBP).Methods A total of 86 patients who underwent TURP in our hospital during Sep.2019 and Jul.2021 were enrolled and randomly divided into the observation group(n=43,dexmedetomidine combined with penehyclidine hydrochloride treatment)and control group(n=43,penehyclidine hydrochloride alone).The visual analogue scale(VAS)of pain,number of bladder spasms and additional use of analgesics were compared and analyzed between the two groups.The cognitive status,NSE and MBP levels were compared 1 day before operation,and on day 1,3 and 7 after operation.Results The VAS scores at 4 h,8 h,12 h and 24 h after surgery,the frequency of bladder spasm,and additional use of analgesics on day 1 and 3 after surgery were lower in the observation than in the control group(P<0.05).The scores of Mini-Mental State Examination(MMSE)were higher in the observation group than in the control group on day 1,3 and 7 after surgery(P<0.05),while the levels of serum NSE and MBP were lower(P<0.05).Conclusion The preoperative and intraoperative application of dexmedetomidine combined with penehyclidine hydrochloride can achieve good analgesic effect in patients undergoing TURP,and can improve postoperative cognitive impairment by reducing brain cell damage.
作者
邓超
刘少星
孙雪梅
DENG Chao;LIU Shaoxing;SUN Xuemei(Department of Anesthesiology,Chengdu Second People s Hospital,Chengdu 610017,China)
出处
《现代泌尿外科杂志》
CAS
2022年第5期400-403,411,共5页
Journal of Modern Urology
