目的 觀察右美托咪定聯(lián)合舒芬太尼對(duì)肺葉切除手術(shù)患者術(shù)后鎮(zhèn)痛的療效。方法 選擇2014年1月-2016年8月在延安大學(xué)附屬醫(yī)院行開(kāi)胸式肺葉切除術(shù)的患者80例，隨機(jī)分為兩組，每組40例。對(duì)照組患者術(shù)后鎮(zhèn)痛給予舒芬太尼0.05 μg/（kg·h），觀察組患者術(shù)后鎮(zhèn)痛采用舒芬太尼0.03 μg/（kg·h）聯(lián)合右美托咪定0.07 μg/（kg·h）。分別記錄患者術(shù)后1、6、12、24、48 h的血液動(dòng)力學(xué)變化、VAS評(píng)分、Ramsay評(píng)分和術(shù)后不良反應(yīng)發(fā)生的情況。結(jié)果 所有患者術(shù)后血流動(dòng)力學(xué)相對(duì)穩(wěn)定，但是觀察組患者較對(duì)照組更穩(wěn)定，有助于患者術(shù)后的恢復(fù)，其中觀察組患者平均動(dòng)脈壓（MAP）、心率（HR）、舒張壓（DBP）等生命指征在12 h時(shí)明顯低于對(duì)照組患者，收縮壓（SBP）在6 h之后低于對(duì)照組患者，且差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）。但是兩組患者術(shù)后相同時(shí)間點(diǎn)的血氧飽和度（SpO₂）沒(méi)有明顯的差異。所有患者在術(shù)后VAS評(píng)分均低于4分，達(dá)到鎮(zhèn)痛目標(biāo)水平，觀察組患者與對(duì)照組比較，VAS評(píng)分在術(shù)后6 h之后明顯降低，且差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。觀察組Ramsay評(píng)分在術(shù)后6 h和12 h兩個(gè)時(shí)間點(diǎn)較對(duì)照組明顯升高，差異具有統(tǒng)計(jì)學(xué)意義（P<0.05），所有患者Ramsay評(píng)分均在2~4分，均未出現(xiàn)鎮(zhèn)靜不足或過(guò)度。與對(duì)照組比較，觀察組出現(xiàn)惡心嘔吐（2.5%）和頭暈（0%）的發(fā)生率明顯降低，差異存在統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 右美托咪定聯(lián)合舒芬太尼用于肺葉切除術(shù)患者術(shù)后疼痛的緩解，可以提高患者鎮(zhèn)靜鎮(zhèn)痛狀態(tài)，改善血流動(dòng)力，降低舒芬太尼引發(fā)的副作用，值得臨床上進(jìn)一步推廣應(yīng)用。

Objective To evaluate the effect of sufentanil combined with dexmedetomidine on analgesia in patients with pulmonary lobectomy.Method Totally 80 patients with pulmonary lobectomy in Yanan University Affiliated Hospital were collected from January 2014 to August 2016, which randomly divided into two groups:patients in control group (n=40) were given sufentanil 0.05 μg/(kg·h), and patients in observation group (n=40) were given sufentanil 0.03 μg/(kg·h) combined with dexmedetomidine 0.07 μg/(kg·h), The differences of hemodynamic change, VAS and Ramsay score, and adverse reaction at 1 h, 6 h, 12 h, 24 h and 48 h after operation were compared.Results The hemodynamic change of all patients were relatively stable, and the more stable group B with lower MAP, HR and DBP at 12 h, and SBP at 6 h after operation further contributed the recovery of patients, which difference compared with group A was significance (P<0.05). However, the difference of SpO₂ at the same time after operation was no significance. The VAS score blow 4 showed that the analgesia of all patients was satisfying. Comparing group B with group A, the VAS score was lower after 6 h at post-operation, which difference was significance (P<0.05). The Ramsay score of group B was higher than group A at 6 h and 12 h, which difference was significance (P<0.05). The Ramsay score with range from 2 to 4 showed the sedation of all patients was not deficient or excessive. The incidence of nausea and vomit (2.5%) and dizziness (0%) in group B was lower than group A, with significant difference between two groups (P<0.05).Conclusion Combination dexmedetomidine with sufentanil to relief postoperative pain in patients undergoing pulmonary lobectomy is deserved popularization in clinic, which not only increases the efficiency analgesia and sedation, improves hemodynamic, but also decreases sufentanil-induced side-effect.