盐酸右美托咪定在剖宫产患者术后镇痛中的应用

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1、授予单位代码10089学号或申请号13661HebeiMedicalUniversity硕士学位论文在职科学学位盐酸右美托咪定在剖宫产患者术后镇痛中的应用学位申请人：田志鹏导师：徐雪副教授专业：麻醉学二级学院：第二医院2015年3月河北医科大学学位论文使用授权及知识产权归属承诺本学位论文在导师(或指导小组)的指导下，由本人独立完成。本学位论文研究所获得的研究成果，其知识产权归河北医科大学所有。河北医科大学有权对本学位论文进行交流、公开和使用。凡发表与学位论文主要内容相关的论文,第一署名为单位河北医科大学，试验材料、原始数据、申报的专利等知识产权均归河北医科大学所有。否则,承担相应法律责任。

2、研究生签名：帘尤导师签章：级学院领导盖章：#5年夕月仏日河北医科大学研究生学位论文独创性声明本论文是在导师指导下进行的研究工作及取得的研究成果，除了文中特别加以标注和致谢等内容外,文中不包含其他人已经发表或撰写的研究成果,指导教师对此进行了审定。本论文由本人独立撰写,文责自负。研究生签名：函thhi导师签章：v>iy年夂月u日目录中文摘要·············································································1英文摘要··············································

3、·······························3研究论文盐酸右美托咪定在剖宫产患者术后镇痛中的应用前言·············································································6材料与方法····································································7结果·············································································9附图·····

4、········································································10附表·············································································13讨论·············································································15结论····························································

5、·················18参考文献·······································································19综述产科术后镇痛································································22致谢···················································································32个人简历·····································

6、········································33中文摘要盐酸右美托咪定在剖宫产患者术后镇痛中的应用摘要目的：术后疼痛会对机体产生诸多负面影响，包括对心血管系统、呼吸系统、内分泌系统、免疫系统等，并且还可能形成对疼痛恐惧的记忆，迁延成为慢性疼痛甚至神经病理性疼痛、或精神系统障碍，如抑郁症等。具体到产科术后疼痛除上述影响外还会影响到产妇照料新生儿、影响母婴沟通、影响哺乳等。所以产科术后镇痛就显得尤为重要。但在产科术后镇痛过程中必须考虑到产妇本身的病理生理变化即正常的子宫收缩对减少产后出血量至关重要，另要考虑到镇痛药物是否会通过乳汁分泌影响到新生儿，所以产科术

7、后镇痛模式、镇痛时机、镇痛药物选择尤为重要，总的原则是：既要镇痛达到目标要求、又要使药物在应用过程中副作用最小，从而对母体宫缩不会引起不良影响，对产后泌乳、新生儿达到最小程度的干扰；盐酸右美托咪定(Dexmedetomidine)为一种新型高效的α2AR激动剂，它与α2、α1肾上腺受体结合的比例是1600/1；与α2AR的亲和力比[1]可乐定高7倍。Dex作用在周围神经系统、中枢神经系统和其他器官组织的α2AR，不仅产生