右美托咪定对胫腓骨骨折患者疼痛阈值及应激反应程度的影响

发布时间：2018-02-09 12:47

本文关键词： 胫腓骨骨折右美托咪定创伤后应激氧化应激机械痛阈踝关节功能　出处：《山东医药》2017年48期 　论文类型：期刊论文

【摘要】：目的探讨右美托咪定对胫腓骨骨折患者疼痛阈值及应激反应程度的影响。方法选取胫腓骨骨折患者80例,随机分为观察组和对照组各40例;观察组术前缓慢静注0.4μg/kg右美托咪定,对照组给予等量生理盐水,其余麻醉方法相同。分别于术前及术后6、12、24、48 h检测两组机械痛阈值;术前及术后2 h检测创伤后应激指标血糖(BS)、去甲肾上腺素(NE)、肾上腺素(E)、皮质醇(Cor)、醛固酮(ALD),以及氧化应激指标谷胱甘肽过氧化物酶(GSH-PX)、超氧化物歧化酶(SOD)、丙二醛(MDA)及晚期氧化蛋白产物(AOPP);术后2个月评价踝关节功能改善情况。结果两组术前机械痛阈值比较差异无统计学意义(P0.05),观察组术后6、12、24、48 h机械痛阈值均高于对照组(P均0.05)。两组术后2 h血清BS、NE、E、Cor、ALD水平均较术前降低,且观察组均低于对照组(P均0.05)。两组术后2 h血清MDA、AOPP水平均较术前升高,血清GSH-PX、SOD水平均较术前降低,且对照组上述指标变化均更显著(P均0.05)。术后2个月时观察组踝关节功能改善率为92.5%,高于对照组的80.0%(P0.05)。结论右美托咪定可降低胫腓骨骨折患者疼痛阈值及应激反应程度,促进踝关节功能康复。
[Abstract]:Objective to investigate the effect of dexmetomidine on pain threshold and stress response in patients with tibia and fibula fracture. Methods 80 patients with tibiofibula fracture were randomly divided into observation group (n = 40) and control group (n = 40). The control group was given the same amount of normal saline and the other anesthetic methods were the same. Blood glucose, noradrenaline, epinephrine, cortisol, aldosterone, glutathione peroxidase (GSH-PX), superoxide dismutase (SOD) and malondialdehyde (MDAs) were measured before and 2 hours after operation. The functional improvement of ankle joint was evaluated 2 months after operation. Results there was no significant difference in the threshold of mechanical pain between the two groups before operation (P 0.05). The mechanical pain threshold of the observation group was higher than that of the control group (P < 0.05). The ALD levels of serum BSN and EPC in group A were lower than those before operation at 2 h after operation. The levels of serum MDA-AOPP in both groups were higher than those before operation, and the levels of serum GSH-PXX SOD were lower than those before operation. At 2 months after operation, the improvement rate of ankle function in the observation group was 92.5, which was higher than that in the control group. Conclusion dexmetomidine can reduce the pain threshold and stress response of the patients with tibia and fibula fracture. To promote functional rehabilitation of ankle joint.
【作者单位】：北京市通州中医医院;
【分类号】：R614

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