不同剂量的右美托咪定对老年股骨粗隆间骨折患者术后认知功能的影响  

Effects of Different Doses of Dexmedetomidine on Postoperative Cognitive Function in Elderly Patients with Femoral Intertrochanteric Fracture

作　　者：吴雯娟[1] 李帆[1] 

机构地区：[1]新疆医科大学第五附属医院麻醉科,新疆乌鲁木齐830001

出　　处：《锦州医科大学学报》2017年第2期31-33,91,共4页Journal of Jinzhou Medical University

摘　　要：目的分析不同剂量右美托咪啶对老年股骨粗隆间骨折患者术后认知功能的影响。方法选取在我院诊治的56例老年股骨粗隆间骨折患者作为研究对象,随机分为3组,高剂量组19例:右美托咪啶0.8μg/(kg·h),中剂量组18例:右美托咪啶0.5μg/(kg·h),低剂量组19例:右美托咪啶0.2μg/(kg·h),观察并比较3组患者术后不同时间的认知功能。结果术后72 h,高、中、低剂量组MMSE评分分别为(25.87±5.12)分、(27.69±5.35)分、(23.47±4.88)分,低剂量组得分显著低于中、高剂量组,经t检验,组间差异有统计学意义,P<0.05;术后12 h,高、中、低剂量组认知功能障碍发生率分别为21.05%、11.11%、52.63%,经卡方检验,组间差异有统计学意义,P<0.05;术后72 h,高、中、低剂量组认知功能障碍发生率分别为0%、0%、26.32%,经Fisher精确检验,组间差异有统计学意义,P<0.05;高、中、低剂量组的不良反应总发生率分别为52.63%、27.78%和68.42%,经卡方检验,差异有统计学意义,P<0.05。结论不同剂量的右美托咪啶对老年股骨粗隆间骨折患者术后认知功能影响差别较大,0.5μg/(kg·h)剂量对患者术后认知功能影响最小,不良反应发生率低。Objective To analyze effects of different doses of dexmedetomidine on postoperative cognitive function in elderly patients with femoral intertrochanteric fracture.Methods 56 elderly patients with intertrochanteric fracture in our hospital were selected as the research object and were randomly divided into 3 groups,with 19 cases of high-dose group,dexmedetomidine 0.8 μg/（kg·h）,18 cases of medium-dose group,dexmedetomidine 0.5 μg/（kg·h）,and 19 cases of low-dose group,dexmedetomidine 0.2 μg/（kg·h）.The cognitive functions of 3 groups were observed and compared at different time after operation.Results 72h after surgery,the score of MMSE in high,medium and low dose group were （25.87±5.12） points,（27.69 ± 5.35） points and （23.47±4.88） points respectively.The scores of the low-dose group were significantly lower than those of the middle and high dose group.The differences between groups were statistically significant by t test,P〈0.05.12 h after surgery,the cognitive dysfunction rate of the high,medium and low dose group were 21.05%,11.11% and 52.63% respectively.The differences between groups were statistically significant by the Chi-square test,P〈0.05.72 h after surgery,the cognitive dysfunction rate in the high,medium and low dose group were 0%,0% and 26.32% respectively.The differences between groups were statistically significant by the Fishers exact test,P〈0.05.The total incidence of adverse reactions in the high,medium and low dose group were 52.63%,27.78% and 68.42% respectively.The differences were statistically significant by Chi-square test,P〈0.05.Conclusion Different doses of dexmedetomidine vary significantly in terms of postoperative cognitive function influence in elderly patients with femoral intertrochanteric fracture.0.5 μg/（kg·h） dose has the minimal impact on postoperative cognitive function,with low incidence of adverse reactions.

关 键 词：右美托咪啶 剂量 认知功能 麻醉 

分 类 号：R614[医药卫生—麻醉学]