右美托咪定对老年患者腹腔镜卵巢癌根治术后苏醒与认知功能的影响  

作　　者：刘铁军[1] 张树波[1] 韩晓亮[1] 高秀江[1] 高晓增[1] 

机构地区：[1]河北联合大学附属医院,063000

出　　处：《浙江临床医学》2015年第3期346-348,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨右美托咪定对老年患者腹腔镜卵巢癌根治术后苏醒与认知功能的影响。方法选取2010年10月至2013年12月行腹腔镜卵巢癌根治术的老年患者134例，采用随机数字表法分为两组，67例患者行右美托咪定泵注为观察组，67例患者行生理盐水泵注为对照组，采用简易精神状态量表（MMSE）评定患者的认知功能，比较两组患者相关临床指标的改变情况、术后苏醒时间、苏醒期的躁动情况、认知功能状况、不良反应情况。结果观察组患者心率、平均动脉压、中心静脉压、心输出量、肾上腺素、去甲肾上腺素变化平稳，未见明显波动。对照组患者心率、平均动脉压、心输出量、肾上腺素、去甲肾上腺素在T1时均显著升高。对照组患者中心静脉压在T1时显著降低。观察组患者在T1、T2、T3、T4时心率、平均动脉压、心输出量、肾上腺素、去甲肾上腺素均明显低于对照组。观察组患者在T1、T2、T3、T4时中心静脉压明显高于对照组。观察组患者躁动发生率、躁动评分、不良反应发生率均明显低于对照组，观察组患者躁动评级明显好于对照组，差异均有统计学意义（P〈0．05）。两组患者认知功能评分在Tb时均显著降低，在Td时均恢复正常。结论右美托咪定有助于稳定血流动力学指标，预防苏醒期躁动，但可能造成苏醒延迟，对老年患者腹腔镜卵巢癌根治术后认知功能无明显影响，不良反应少，具有较高的安全性，值得临床推广使用。Objective To investigate influence of dexmedetomidine on postoperative awakening and cognitive function in elderly patients with laparoscopic resection of ovarian cancer. Methods 134 elderly patients with laparoscopic resection of ovarian cancer were selected in hospital from October 2010 to December 2013, who were randomly divided into two groups.67 patients treated dexmedetomidine infusion as observation group. 67 patients treated saline infusion as control group. Cognitive function was evaluated by mini mental state examination （ MMSE ） . Changes of related clinical indexes, postoperative awaken time, agitation during awaken period, cognitive function, adverse reactions were compared between two groups. Results Changes of HR, MAP, CVP, CO, epinephrine, norepinephrine in observation group were smooth, which had no obvious fluctuation. In control group, HR, MAP, CO, epinephrine, norepinephrine increased significantly at T1, while CVP decreased significantly at T1. HR, MAP, CO, epinephrine, norepinephrine at T1, T2, T3, T4 in observation group were significantly lower than control group. CVP at T1, T2, T3, T4 in observation group were significantly higher than control group.Incidence of agitation, agitation score, incidence of adverse reactions in observation group were significantly lower than control group. Agitation rating in observation group was significantly better than control group. Differences were statistically significant （ P〈0.05 ） . Cognitive function score decreased significantly at Tb~ while restored to normal at Td in two groups. Conclusions Dexmedetomidine helps to stabilize hemodynamics, which can prevention agitation during awaken period. Dexmedetomidine may cause awareness delay, which has no significant influence on cognitive function in elderly patients with laparoscopic resection of ovarian cancer. Dexmedetomidine has less adverse reaction and high security, which is worthy of clinical use.

关 键 词：右美托咪定 腹腔镜 卵巢癌根治术 

分 类 号：R737.31[医药卫生—肿瘤]