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目的:观察右美托咪定术后持续泵注对老年肺癌患者术后心律失常的影响。方法:选取在我院胸科接受手术治疗的肺癌患者100例,随机分成2组(n=50):地佐辛+氟比洛芬酯组(A组)和地佐辛+氟比洛芬酯+右美托咪定组(B组)。手术结束前半小时静注地佐辛5 mg和氟比洛芬酯100 mg,术毕连接患者自控镇痛泵(PCIA)。A组中加入地佐辛20 mg和氟比洛芬酯300 mg,而B组中加入地佐辛20 mg和氟比洛芬酯300 mg和80μg的右美托咪定。观察并记录患者术后4 h,8 h,24 h和48 h的VAS疼痛评分、Ramsay镇静评分及不良反应(维持VAS评分≤4分,Ramsay评分2~4分),监测心电图,记录心律失常发生情况。结果:A、B两组术后疼痛、镇静分级、不良反应发生率的差异无统计学意义。A组中17例患者术后发生心律失常,明显高于B组(4例)(P<0.05)。结论:右美托咪定可减少老年肺癌患者术后心律失常的发生,且无明显不良反应。
Objective: To observe the effect of continuous infusion of dexmedetomidine on postoperative arrhythmia in elderly patients with lung cancer. Methods: One hundred patients with lung cancer undergoing thoracic surgery in our hospital were randomly divided into 2 groups (n = 50): dezocine + flurbiprofen axetil group (group A) and dezocine + flurbiprofen Ester + dexmedetomidine group (group B). Intravenous dezocine 5 mg and flurbiprofen axetil 100 mg were given intravenously one and a half hours before the end of surgery, and patient-controlled patient-controlled analgesia pump (PCIA) was performed. In group A, dezocine 20 mg and flurbiprofen axetil 300 mg were added, while in group B dezocine 20 mg and flurbiprofen axetil 300 mg and 80 μg of dexmedetomidine were added. VAS pain scores, Ramsay sedation scores and adverse reactions at 4 h, 8 h, 24 h and 48 h after operation were recorded and recorded. VAS score ≤4 and Ramsay score 2-4 were monitored. Electrocardiogram was recorded and arrhythmia was recorded What happened? Results: There was no significant difference in postoperative pain, sedation grade and incidence of adverse reactions between groups A and B. Seventeen patients in group A had arrhythmia after operation, which was significantly higher than that in group B (n = 4) (P <0.05). Conclusion: Dexmedetomidine can reduce the incidence of postoperative arrhythmia in elderly patients with lung cancer without obvious adverse reactions.