目的 探究盐酸纳布啡联合右美托咪定对腹腔镜减重手术患者术后恢复质量及疼痛的影响。 方法 纳入我院择期行腹腔镜减重手术患者169例，采用随机数字表法分为4组：对照组（C组）、纳布啡组（N组）、右美托咪定组（D组）和纳布啡联合右美托咪定组（ND组）。C组静脉注射生理盐水，N组与ND组于手术结束前静脉注射纳布啡，D组与ND组于麻醉诱导前和术中泵注右美托咪定。比较4组患者术后恢复质量评分（QoR-40）、不同时间点的血流动力学、视觉模拟评分（VAS）、Ricker镇静-躁动评分（SAS）、首次下床活动与排气时间、恶心呕吐发生率等。 结果 ND组患者术后QoR-40评分优于C组、N组（P < 0.05），D组QoR-40评分优于C组（P < 0.05）。ND组、D组患者苏醒期MAP和HR更平稳（P < 0.05）。与C组相比，三组患者术后VAS评分、SAS评分更低（P < 0.05），补救镇痛药物消耗更少（P < 0.05）。在不良反应方面，ND组患者较C组术后恶心、呕吐和呛咳的发生率更低（P < 0.05）。 结论 盐酸纳布啡与右美托咪定联合应用可以改善腹腔镜减重手术患者术后早期恢复质量与疼痛，减轻患者苏醒期血流动力学波动，减少恶心呕吐的发生率，改善患者预后情况。

Objective To investigate the effects of nalbuphine combined with dexmedetomidine on postoperative recovery quality and pain in patients who undergoing laparoscopic bariatric surgery. Methods A total of 169 patients who underwent laparoscopic bariatric surgery at our hospital were included and divided into control group （group C）， nalbuphine group （group N）， dexmedetomidine group （group D）， and nalbuphine combined with dexmedetomidine group （group ND） using randomised numerical table method. Group C received intravenous injection of saline， group N and group ND received intravenous injection of nalbuphine before the end of the surgery， and group D and group ND received pumping of dexmedetomidine before anesthesia induction and during surgery. Compare the postoperative recovery quality score （QoR?40）， hemodynamics at different time points， visual analogue scale score （VAS）， sedation?agitation scale （SAS）， first time out of bed activity and exhaust time， and incidence of nausea and vomiting among four groups. Results The postoperative QoR?40 scores of patients in group ND were better than those in group C and group N （P < 0.05）， and the QoR?40 scores in group D were better than those in group C （P < 0.05）. MAP and HR were more stable during the awakening period in group ND and group D （P < 0.05）. Compared with group C， patients in all three groups had lower VAS scores and SAS scores （P < 0.05） and consumed less remedial analgesic medication（P < 0.05）. In terms of adverse reactions， the incidence of postoperative nausea， vomiting and coughing in the group ND was lower than that in the group C （P < 0.05）. Conclusion The combination of nalbuphine and dexmedetomidine could improve the quality of postoperative recovery and pain in patients undergoing laparoscopic bariatric surgery， reduce hemodynamic fluctuations during the patients′ recovery period， reduce the incidence of nausea and vomiting， and improve the patients′ prognosis.