右美托咪定预防老年患者术后早期认知功能障碍的研究  

The study the dexmedetomidine of prevention early postoperative cognitive dysfunction of older patients

作　　者：陈学均[1] 代月娥[1] 

机构地区：[1]四川省医学科学院.四川省人民医院麻醉科,四川成都610072

出　　处：《实用医院临床杂志》2013年第5期81-83,共3页Practical Journal of Clinical Medicine

摘　　要：目的探讨右美托咪定对老年患者不同麻醉方式术后认知功能障碍的影响。方法将60例接受胃癌根治手术的老年患者分为静吸复合麻醉组(I组)、右美托咪定+全凭静脉麻醉组(II组)、右美托咪定+全凭吸入麻醉组(III组),分别在术前1 d及术后1、3、7 d进行简易智力状态检查(mini-mental state examination,MMSE)评分,观察记录患者麻醉诱导前30 min(T0)、气管插管即刻(T1)、切皮(T2)、气管拔管(T3)时的血压、心率、术中麻醉药物用量和拔出气管导管的时间。结果与术前比较,三组患者MMSE评分在术后1、3 d均有不同程度的下降(P>0.05);II、III组与I组比较在术后1 d差异有统计学意义(P<0.05),其余时点差异无统计学意义(P>0.05)。三组患者血压、心率与T0比较,II组和III组在T1、T2、T3、T4无明显变化,I组差异有统计学意义(P<0.05)。结论右美托咪定可使老年患者术中血流动力学更稳定,降低老年患者术后POCD的发生率,并减轻其发病程度。Objective To explore the influence of dexmedetomidine on the postoperative cognitive dysfunction （POCD）. Methods Sixty ASA Ⅰor Ⅱ patients undergoing gastric cancer surgery in elderly patients were randomly divided into three groups： group Ⅰ received intravenous anesthesia combined with the inhalation anesthesia; group Ⅱ received dexmedetomidine for sedation and total intravenous anesthesia（TIVA）and group Ⅲ received dexmedetomidine combined with the inhalation anesthesia. The mini-metal state examination（MMSE） was used to assess the cognitive function before and 1 d,4 d,7 d after operation. The blood pressure, heart rate,the intraoperative anesthesia durg dosage and the time of extubation was recorded. Results The MMSE of the patients in three groups were declined in the first day and third day after the operation（ P 〈 0.05 ）. The MMSE score in group Ⅱ and group Ⅲ were sig- nifican different compared to group Ⅰ in the first day after the operation. The blood pressure and heart rate in group Ⅰ were different com- pared to the group Ⅱ and group Ⅲ （ P 〈 0.05 ）. Conclusion The Dexmedetomidine provide stable hemodynamics in elderly patients during the period of operation, decrease the rate of POCDand lighten the degree after the operation.

关 键 词：右美托咪定 老年患者 简易智力状态检查 术后认知功能障碍 

分 类 号：R614.2[医药卫生—麻醉学]