不同剂量盐酸右美托咪定对老年患者术后急性期的影响  

Effect of dexmedetomidine hydrochloride in different doses on cognitive function in elderly patients with postoperative acute stage

作　　者：郑翔丽[1] 张梅[1] 杨占民[1] 程利锋[1] 

机构地区：[1]航天中心医院麻醉科,北京100049

出　　处：《海南医学院学报》2016年第10期1037-1040,共4页Journal of Hainan Medical University

基　　金：航天中心医院科研课题项目(YN2013TS08)~~

摘　　要：目的：探讨不同剂量盐酸右美托咪定对老年患者术后急性期的影响。方法：选择2014年9月~2015年9月我院接诊的120例需进行手术的老年患者,按照随机数表法分为观察组（60例）和对照组（60例）,观察组、对照组在麻醉过程中分别使用0.5、1.0μg/kg的盐酸右美托咪定。观察两组患者在T_0、T_1、T_2、T_3时间点肿瘤坏死因子-α（TNF-α）、白介素-2（IL-2）水平的变化,对拔管时间、清醒时间和不良反应进行记录,观察手术前1d和手术后1dMMSE评分以及术后认知功能障碍（POCD）发生率。结果：T3时间点时,观察组TNF-α、IL-2水平[（3.80±0.62）、（1.95±0.43）pg/mL]低于对照组[（4.13±0.68）、（2.43±0.51）pg/mL]（P〈0.05）;观察组拔管时间、清醒时间[（21.89±5.23）、（25.07±6.21）min]均短于对照组[（26.17±6.04）、（29.54±6.30）min],不良反应发生率（15.00%,9/60）低于对照组（43.33%,26/60）（P〈0.05）;手术后,观察组MMSE评分（25.89±2.35）大于对照组（24.41±2.18）,观察组POCD发生率（1.67%,1/60）低于对照组（11.67%,7/60）,差异具有统计学意义（P〈0.05）。结论：在老年患者的麻醉前使用0.5μg/kg的盐酸右美托咪定泵入,在麻醉维持期仍使用0.5μg/kg的剂量进行维持泵注,可以减少POCD的发生率,苏醒快,副作用少。Objective：explore the effect of dexmedetomidine hydrochloride in different doses on cognitive function in elderly patients with postoperative acute stage.Methods：A total of 120 elderly patients who were admitted in our hospital from September,2014 to September,2015 for operation were included in the study and randomized into the observation group and the control group with 60 cases in each group.The patients in the observation group were given 0.5μg/kg dexmedetomidine hydrochloride during the anesthesia process,while the patients in the control group were given 1.0μg/kg dexmedetomidine hydrochloride.The changes of tumor necrosis factor（TNF）-αand interleukin（IL）-2levels at the timing points of T0,T1,T2,and T3 in the two groups were observed.The extubation time,awaking time,and adverse reactions were recorded.MMSE score and the occurrence rate of post operative cognitive dysfunction（POCD）1dbefore operation and 1dafter operation were observed.Results：At the time of T3,TNF-αand IL-2levels in the observation group [（3.80±0.62）,（1.95±0.43）pg/mL]were significantly lower than those in the control group[（4.13±0.68）,（2.43±0.51）pg/mL]（P〈0.05）.The extubation time and awaking time in the observation group[（21.89±5.23）,（25.07±6.21）min]were significantly lower than those in the control group[（26.17±6.04）,（29.54±6.30）min]Z The occurrence rate of adverse reactions in the observation group（15.00%,9/60）was significantly lower than that in the control group（43.33%,26/60）（P〈0.05）.After operation,MMSE score in the observation group（25.89±2.35）was significantly greater than that in the control group（24.41±2.18）（P〈0.05）.The occurrence rate of POCD in the observation group（1.67%,1/60）was significantly lower than that in the control group（11.67%,7/60）（P〈0.05）.Conclusions：Pumping of 0.5μg/kg dexmedetomidine hydrochloride before anesthesia in the elderly patients and 0.5μg/kg during the anesthesia maintenance period can reduce

关 键 词：盐酸右美托咪 老年患者 认知功能 

分 类 号：R614[医药卫生—麻醉学]