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400037 重庆,陆军军医大学(第三军医大学)第二附属医院麻醉科
[ 李洪,E-mail:lh78553@163.com LI Hong, E-mail:lh78553@163.com
收稿:2020-01-03,
修回:2020-01-22,
纸质出版:2020-05-30
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王开, 段光友, 赵鹏, 等. 右美托咪定术中持续泵注对脊柱手术患者术后睡眠质量的改善作用[J]. 第三军医大学学报, 2020,42(10):1002-1007.
Kai WANG, Guangyou DUAN, Peng ZHAO, et al. Effects of intraoperative continuous pumping of dexmedetomidine on postoperative sleep quality in patients undergoing spinal surgery[J]. Journal of Third Military Medical University, 2020, 42(10): 1002-1007.
王开, 段光友, 赵鹏, 等. 右美托咪定术中持续泵注对脊柱手术患者术后睡眠质量的改善作用[J]. 第三军医大学学报, 2020,42(10):1002-1007. DOI: 10.16016/j.1000-5404.202001016.
Kai WANG, Guangyou DUAN, Peng ZHAO, et al. Effects of intraoperative continuous pumping of dexmedetomidine on postoperative sleep quality in patients undergoing spinal surgery[J]. Journal of Third Military Medical University, 2020, 42(10): 1002-1007. DOI: 10.16016/j.1000-5404.202001016.
目的
2
探讨术中持续泵注右美托咪定(dexmedetomidine
DEX)对脊柱手术患者术后睡眠质量的影响。
方法
2
从陆军军医大学第二附属医院的病历系统中收集从2018年5月至2019年4月在本院行脊柱手术的3 257例患者。根据术中是否泵注右美托咪定将患者分为右美托咪定(DEX)组和未使用右美托咪定的对照(CON)组。记录患者术后当晚睡眠障碍发生情况,包括睡眠剥夺及反复睡眠中断,并比较两组睡眠障碍发生率。同时,采用倾向性匹配性分析和亚组分析对两组睡眠障碍发生率进行进一步验证。
结果
2
DEX组患者术后当晚睡眠障碍的发生率为17.4%,显著低于CON组的29.4%(
P
<
0.000 1);倾向性匹配后,DEX组和CON组术后当晚睡眠障碍的发生率分别为18.5%和29.4%,DEX组显著低于CON组(
P
<
0.000 1)。亚组分析结果显示,颈椎、胸椎、腰椎手术患者术后当晚睡眠障碍在DEX组均低于CON组,分别为(20.3%
vs
28.9%,
P
=0.025)、(14.6%
vs
18.2%,
P
=0.580)、(16.9%
vs
30.2%,
P
<
0.000 1)。
结论
2
术中右美托咪定持续泵注能够改善脊柱手术患者的术后睡眠质量,减少脊柱手术患者术后睡眠障碍的发生。
Objective
2
To investigate the effects of intraoperative continuous pumping of dexmedetomidine on postoperative sleep quality in patients undergoing spinal surgery.
Methods
2
We retrospectively analyzed the data of 3 257 patients undergoing spinal surgery between May
2018 and April
2019 collected from the medical record system of the Second Affiliated Hospital of Army Medical University. The patients were divided into dexmedetomidine (DEX) group and control group according to whether the patients received intraoperative continuous pumping of DEX. The occurrence of sleep disturbance on the first postoperative night (including sleep deprivation and repeated sleep disruption) was recorded and the incidence of sleep disturbance was compared between the 2 groups. Propensity score matching and subgroup analysis were carried out to further verify the incidences of sleep disturbance in the 2 groups.
Results
2
The incidence of sleep disturbance on the first postoperative night was 17.4% in DEX group and 29.4% in the control group (
P
<
0.000 1) in the unmatched cohort; the incidence was 18.5% the DEX group and 29.4% in the control group (
P
<
0.000 1) after propensity matching. Subgroup analysis showed that the incidence of severe sleep disturbance was significantly lower in DEX group than in the control group following cervical vertebra surgeries (20.3%
vs
28.9%
P
=0.025)
thoracic surgeries (14.6%
vs
18.2%
P
=0.580) and lumbar surgeries (16.9%
vs
30.2%
P
<
0.000 1).
Conclusion
2
Intraoperative continuous pumping of DEX helps to improve postoperative sleep quality and lower the incidence of postoperative sleep disturbance in patients undergoing spinal surgeries.
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