醒脑静与右美托咪定联合防治老年髋部骨折患者术后谵妄的临床有效性  

Effect of Xingnaojing Combined with Dexmedetomidine on the Development of Postoperative Delirium in Older Patients with Hip Fracture

作　　者：赵志辉[1] 孙国林[1] Zhao Zhihui;Sun Guolin(Qinhuangdao Haigang Hospital,Qinhuangdao 066000,China)

机构地区：[1]河北省秦皇岛市海港医院

出　　处：《国际老年医学杂志》2018年第6期305-309,共5页International Journal of Geriatrics

基　　金：秦皇岛市科技支撑计划项目(201602A130);湖北省卫生和计划生育委员会科研项目(WJ2017M60)

摘　　要：目的 探讨醒脑静及右美托咪定联用防治老年髋部骨折患者术后谵妄的临床有效性.方法 选取2015 年1 月~2017 年5 月于本院手术治疗髋部骨折的老年患者68 例, 随机分为对照组32 例应用右美托咪定治疗, 实验组36 例在对照组治疗基础上加用醒脑静.记录两组谵妄防治情况及镇静、疼痛状况等.结果 对照组术后谵妄发生率(31. 25% )比实验组(11. 11% )高, 差异有统计学意义(P<0. 05); 治疗后实验组S100 -β蛋白(0. 81 ± 0. 15) μg/L比对照组(1. 70 ± 0. 28) μg/L低, 差异有统计学意义( P<0. 05) ; 实验组谵妄现象持续时间(2. 43 ± 1. 25) h 比对照组(3. 70 ± 1. 37) h 短, 差异有统计学意义(P<0. 05); 实验组术后各时间节点镇静水平及其疼痛程度均优于对照组, 差异有统计学意义(P<0. 05).结论 对于患有髋部骨折的老年患者, 施予手术治疗的基础上, 联合应用醒脑静与右美托咪定防治术后谵妄疗效更佳, 值得选用.Objective To explore the effect of Xingnaojing combined with dexmedetomidine in the prevention and treatment of postoperative delirium in older patients with hip fracture. Methods 68 older patients with hip fracture treated in our hospital be-tween January 2015 and May 2017 were enrolled and randomly divided into two groups. 32 patients in the control group received dexmedetomidine. 36 patients in the experimental group received dexmedetomidine and Xingnaojing. Delirium, sedation and pain were assessed. Results After treatment, the incidence of postoperative delirium in the experimental group (11. 11% ) was lower than that in the control group (31. 25% ) (P<0. 05). The level of S100-β protein in the experimental group [ (0. 81 ± 0. 15) μg/L] was lower than that in the control group [ (1. 70 ± 0. 28) μg/L] (P<0. 05). The duration of delirium in the experimental group [ (2. 43 ± 1. 25) h] was shorter than that in the control group [ (3. 70 ± 1. 37) h] (P<0. 05). Sedation level and pain relief in the experimental group were better than those in the control group ( P <0. 05). Conclusion Combination of Xingnaojing and dexmedetomidine is effective in the prevention and treatment of postoperative delirium for older patients who undergo surgery for hip fracture.

关 键 词：醒脑静 髋部骨折 老年患者 右美托咪定 谵妄 

分 类 号：R614[医药卫生—麻醉学]