目的 观察右美托咪定联合舒芬太尼对肺叶切除手术患者术后镇痛的疗效。方法 选择2014年1月-2016年8月在延安大学附属医院行开胸式肺叶切除术的患者80例，随机分为两组，每组40例。对照组患者术后镇痛给予舒芬太尼0.05 μg/（kg·h），观察组患者术后镇痛采用舒芬太尼0.03 μg/（kg·h）联合右美托咪定0.07 μg/（kg·h）。分别记录患者术后1、6、12、24、48 h的血液动力学变化、VAS评分、Ramsay评分和术后不良反应发生的情况。结果 所有患者术后血流动力学相对稳定，但是观察组患者较对照组更稳定，有助于患者术后的恢复，其中观察组患者平均动脉压（MAP）、心率（HR）、舒张压（DBP）等生命指征在12 h时明显低于对照组患者，收缩压（SBP）在6 h之后低于对照组患者，且差异均有统计学意义（P<0.05）。但是两组患者术后相同时间点的血氧饱和度（SpO₂）没有明显的差异。所有患者在术后VAS评分均低于4分，达到镇痛目标水平，观察组患者与对照组比较，VAS评分在术后6 h之后明显降低，且差异具有统计学意义（P<0.05）。观察组Ramsay评分在术后6 h和12 h两个时间点较对照组明显升高，差异具有统计学意义（P<0.05），所有患者Ramsay评分均在2~4分，均未出现镇静不足或过度。与对照组比较，观察组出现恶心呕吐（2.5%）和头晕（0%）的发生率明显降低，差异存在统计学意义（P<0.05）。结论 右美托咪定联合舒芬太尼用于肺叶切除术患者术后疼痛的缓解，可以提高患者镇静镇痛状态，改善血流动力，降低舒芬太尼引发的副作用，值得临床上进一步推广应用。

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.