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目的:探究围手术期应用右美托咪定（dexmedetomidine, Dex）对肾源性继发性甲状旁腺功能亢进症（secondary hyperparathyroidism, SHPT）患者术后复发的影响。方法:回顾性分析2017年1月—2018年8月于安徽医科大学第二附属医院行甲状旁腺全切＋自体移植术（total parathyroidectomy+autologous transplantation, tPTX+AT）的354例终末期肾病SHPT患者的病历资料，随访患者术后1年内SHPT是否复发。患者按SHPT是否复发分为复发组（36例）和未复发组（318例），对术后复发的可能相关因素进行单因素和多因素Logistic回归分析。根据术中是否输注Dex将其分为右美托咪定组（Dex组，133例）和对照组（Con组，221例），比较两组患者围手术期相关资料差异。结果:在单因素分析中，复发组年龄高于未复发组，术中使用Dex者少于未复发组（n P<0.05 ）。多因素Logistic回归分析发现，年龄[比值比（odds ratio, OR）=1.081, 95%CI 1.038~1.126 ，n P< 0.001 ]、术后1周内甲状旁腺素（intactparathyroid hormone, iPTH）水平（OR=1.011，95%CI 1.000~1.021 ，n P=0.041）与术中使用Dex(OR=0.222 ，95%CI 0.083~0.594，n P=0.003 ）是肾源性SHPT患者术后复发的影响因素。与Con组比较，Dex组术中舒芬太尼用量减少，PACU期间VAS评分≥4分予以补救镇痛发生率明显降低，心动过缓发生率增高（n P0.05 ）。n 结论:术中使用Dex是肾源性SHPT患者术后复发的保护性因素，并且能够减少术中阿片类药物用量，并提供更为良好的术后镇痛。“,”Objective:To investigatethe the effects of dexmedetomidine (Dex) on postoperative recurrence in patients with renal secondary hyperparathyroidism (SHPT).Methods:A total of 354 renal SHPT patients who underwent total parathyroidectomy and autologous transplantation (tPTX+AT) in the Second Affiliated of Anhui Medical University from January 2017 to August 2018 were enrolled and their clinical data were retrospectively analyzed. All the patients were followed up for recurrence of SHPT within one year after surgery, and they were divided into two groups: a recurrence group (n n=36) and a non-recurrence group (n n=318). Univariate Logistic regression and multivariate Logistic regression were performed to determine the related factors of postoperative recurrence. According to the presence of Dex infusion, they were divided into two groups: a Dex group (n n=133) and a control (Con) group (n n=221), and the differences in perioperative data between the two groups were compared.n Results:According to univariate Logistic regression analysis, the age of recurrence group was higher than that of non-recurrence group, and the incidence of using Dex was less than that of non-recurrence group (n P<0.05). According to multivariate Logistic regression analysis, age [odds ratio (OR)=1.081, 95% confidence interval (CI) 1.038-1.126,n P<0.001], postoperative intactparathyroid hormone (iPTH) level (OR=1.011, 95% CI 1.000-1.021,n P=0.041) as well as intraoperative use of dexmedetomidine (OR=0.222, 95%CI 0.083-0.594, n P=0.003) were the influencing factors of postoperative recurrence in patients with renal SHPT. Compared with the Con group, the Dex group presented remarkable decreases in the dosage of sufentanil and the incidence of salvage analgesia during postanesthesia care unit (PACU), but increases in the incidence of bradycardia (n P0.05).n Conclusions:Intraoperative use of Dex is a protective factor for postoperative recurrence in patients with renal SHPT, which can reduce the dosage of intraoperative opioids and provide better postoperative analgesia.