血浆稳态氧化氮产物与老年颌面外科手术后谵妄的关系  

Relationship between plasma concentrations of stable nitric oxide products and postoperative delirium after oral-maxilloficial surgery in elderly patients

作　　者：郁葱[1] 陈思路[1] 张青[1] 肖水生[2] 罗玉琳[1] 

机构地区：[1]重庆医科大学附属口腔医院麻醉科,400015 [2]重庆医科大学附属口腔医院颌面外科,400015

出　　处：《重庆医学》2010年第4期388-389,392,共3页Chongqing medicine

基　　金：重庆医科大学校级科研资助项目(XBYB2008055)

摘　　要：目的观察老年颌面外科手术患者全身麻醉后术后谵妄(PD)的发病率,研究血浆稳态氧化氮产物浓度与PD的关系。方法选择30例颌面外科手术患者,年龄大于或等于60岁,采用静吸复合麻醉,记录术前(T0),术毕(T1),术后12、24、48h(T2、3、4)PD等级评分[采用谵妄评定量表98修订版(DRS-R-98),DRS-R-98评分高于15.25分者诊断为PD];并测定血浆稳态氧化氮产物(NOx)浓度。结果NOx浓度在T1、2、3明显低于T0,差异有统计学意义(P<0.01);T3、4DRS-R-98评分明显高于T0,差异有统计学意义(P<0.01)。手术后4d内发生PD者NOx浓度在T1、2、3明显高于未发生PD者,差异有统计学意义(P<0.01)。结论老年颌面外科PD发生率为20%;NOx浓度与PD相关,可以作为老年颌面外科PD的预警指标。Objective To determine the incidence of postoperative delirium （PD） after oral and maxillofacial surgery under general anesthesia in old patients and to examine its association width plasma concentrations of stable nitric oxide （NOx） products. Methods Thirty patients who were above 60 years old underwent elective oral maxilloficial surgery. The score of Delirium Rating Scale-Revised-98（DRS-R-98） was recorded before operation （TO） ,at the end of operation （T1）, 12h（T2）, 24h（T3） and 48h（T4） postoperation. Serial measurements of serum concentrations of stable nitric oxide products（nitrate/ nitrite, NOx） were also performed at the same time. Results The concentrations of plasma stable nitric oxide products at T1 ,T2 and T3 were much lower than that at TO significantly（P〈0.01）. However the score of DRS-R-98 at T3,4 was much higher than that at TO significantly（P〈 0.01）. The concentrations of plasma stable nitric oxide products of those who suffered PD at T1,2,3 were much higher than those who hadn＇t suffered PD（P〈0.01）. Conclusion The incidence of postoperative delirium is 20% after oral and maxillofacial surgery. Perioperative plasma concentrations of stable nitric oxide products are associated with postoperative delirium and maybe a potential biochemical predictor of postoperative delirium.

关 键 词：手术后谵妄 老年患者 稳态氧化氮产物 谵妄等级评分修订版 

分 类 号：R782[医药卫生—口腔医学]