全身麻醉前长托宁联合阿托品与长托宁单用对老年患者术后谵妄的影响  

Clinical therapeutic effect analysis of Penehyclidine Hydrochloride Injection uniting atropine and Penehyclidine Hydrochloride Injection on elderly postoperative delirium

作　　者：姜向春[1] 杨丽莹[1] 

机构地区：[1]中国人民解放军第三二一医院,吉林白城137000

出　　处：《现代医药卫生》2015年第10期1453-1454,1457,共3页Journal of Modern Medicine & Health

摘　　要：目的比较麻醉前联合应用长托宁和阿托品与单用长托宁对老年患者术后谵妄的影响。方法选择该院外科行腹部手术全身麻醉老年患者128例,按随机数字表法分为联合组、长托宁1组、长托宁2组和对照组四组,每组32例。术前30 min:长托宁1组使用长托宁0.01 mg/kg肌内注射,长托宁2组使用长托宁0.005 mg/kg肌内注射,对照组使用生理盐水肌内注射,联合组使用长托宁0.005 mg/kg和阿托品0.005 mg/kg肌内注射,麻醉方法均采用全身麻醉。于术前1 d和术后1、2、7 d采用护理谵妄筛查量表(Nu-DESC-SCV)进行谵妄评估,于术前1 d及术后72 h采用简易智力状态量表(MMSE)进行认知功能测定,并进行对比分析。结果与对照组比较,长托宁1组MMSE评分均显著下降,Nu-DESCSCV评分均显著提高,差异均有统计学意义(P<0.05),联合组和长托宁两组与对照组比较,MMSE评分及Nu-DESC-SCV评分下降不显著,差异均无统计学意义(P>0.05),联合组谵妄发生率均明显高于长托宁1组、长托宁2组及对照组,差异均有统计学意义(P<0.05)。结论长托宁联合阿托品能增加老年患者术后谵妄,临床须谨慎使用。Objective To compare diffrent clinical therapeutic effect of Penehyclidine Hydrochloride Injection uniting atropine and Penehyclidine Hydrochloride Injection on postoperative delirium of the elderly. Methods Selected 128 elderly abdominal surgery patients under general anesthesia and randomly divided them into uniting group,Penehyclidine Hydrochloride Injection 1, Penehyclidine Hydrochloride Injection 2, and control group with 32 cases in each one. Gave 0.01 mg/kg Penehyclidine Hydrochloride Injection to Penehyclidine Hydrochloride Injection 1 through intramuscular injection,0.005 mg/kg Penehyclidine Hydrochloride Injection to Penehyclidine Hydrochloride Injection 2 through intramuscular injection, normal saline to control group through intramuscular injection 30 rain before surgery, and put them all under general anesthesia. Gave 0.005 mg/kg Penehyclidine Hydrochloride Injection and 0.005 mg/kg to uniting group through intramuscular injection and carried delirium evaluation on 1 d before surgery and on 2,7 d after surgery using Nu-DESC-SCV, determined cognitive function on 1 d before surgery and of 72 h after surgery using MMSE. The comparative analysis was performed. Results The MMSE ratings of Penehyclidine Hydrochloride Injection 1 reduced prominently and the Nu-DESC-SCV ratings of which rose prominently comparing to control group, differences showing statistic significance （P〈0.05）. The MMSE and Nu-DESC-SCV ratings of uniting group and Penehyclidine Hydrochloride Injection 2 reduced inapparently, differences showing no statistic significance （P〉0.05）. The delirium occurrence rate in the uniting group was clearly more than that in Penehyclidine Hydrochloride Injection 1, difference showing statistic significance （P〈0.05）. Conclusion Penehyclidine Hydrochloride Injection uniting atropine increases postoperative delirium in the elderly and should be used with caution in clinic.

关 键 词：阿托品 奎宁环类 老年人 谵妄 手术后期间 治疗结果 

分 类 号：R473.6[医药卫生—护理学]