右美托咪啶对老年男性病人术后早期认知功能的影响  

The Effect of Dexmedetomidine for Early POCD in Elder Male Patients

作　　者：田阿勇[1] 艾春雨[1] 马虹[1] 

机构地区：[1]中国医科大学附属第一医院麻醉科,辽宁沈阳110001

出　　处：《中国血液流变学杂志》2012年第3期442-443,458,共3页Chinese Journal of Hemorheology

基　　金：辽宁省教育厅课题（2008796）

摘　　要：目的研究右美托咪啶对老年男性病人术后早期认知功能的影响。方法选择ASAⅠ～Ⅱ级，60～75岁择期全麻下手术的男性患者120例。随机分为两组，每组60例。A组：麻醉诱导后静注右美托咪啶，配成4μg／mL浓度以1μg／kg剂量缓慢静注，输注时间超过10min。B组：麻醉诱导后静注等剂量生理盐水。术前用药为长托宁0．5mg静脉注射，麻醉诱导采用咪达唑仑0．03mg／kg、舒芬太尼0．3～0．5μg／kg、罗库溴铵0．6mg／kg、依托咪酯0．3mg／kg缓慢静注，气管插管后接麻醉机行机械通气。麻醉维持采用持续泵注丙泊酚，吸入七氟烷，间断静注罗库溴铵、舒芬太尼维持。术终均给予托烷司琼5mg静注预防恶心呕吐。术中应用多功能监测仪连续监测血压、心率、心电图、脉搏血氧饱和度。记录术前及术后3h MMSE评分。结果两组老年男性病人术后POCD发生率分别为32％和28％，术前及术后MMSE评分组内比较有统计学意义（P〈0．05）。术后MMSE评分组间比较无统计学差异（P〉0．05）。结论右美托咪啶应用于老年男性病人，不增加老年男性术后早期认知功能障碍的风险。Objective To observe the effect of Dexmedetomidine for early POCD in elder male patients. Methods 120 ASA Ⅰ-Ⅱ male patients aged 60 - 75ys under general anesthesia were enrolled in this study.The patients were randomly assigned to two study groups：Group A received Dexmedetomidine,Group B received NS 50mL IV.Anesthesia was induced with midazolam,sufentanyl,rocuronium,propofol,and maintained with inhaled sevoflurane and intravenous propofol.The MMSE scores were observed for the preoperative and postoperative 3h.Results The incidences of POCD were 32% and 28% for elder male patients among Group A and B,there are difference of statistics for the MMSE scores between the preoperative and postoperative（P 〈 0.05）.There are no difference with the postoperative between two groups（P 〉 0.05）.Conclusion Dexmedetomidine was to utilized safely for elder male patients that it did not raise the risk of early POCD.

关 键 词：右美托咪啶 老年男性病人 术后认知功能障碍 

分 类 号：R614.2[医药卫生—麻醉学]