右美托咪定对妇科老年全麻手术患者术后认知功能及炎症因子的影响  

Effects of dexmedetomidine on post-operative cognitive function and inflammatory factors of senile gynecological patients undergoing general anesthesia

作　　者：吕志排[1] 曹静[1] 王涛[1] 王举[1] 连红梅[1] Lv Zhipai Cao Jing Wang Tao Wang Ju Lian Hongmei(The Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan , Chin)

机构地区：[1]郑州大学第三附属医院,河南郑州450000

出　　处：《临床心身疾病杂志》2017年第3期69-71,共3页Journal of Clinical Psychosomatic Diseases

摘　　要：目的 探讨右美托咪定对妇科老年全麻手术患者术后认知功能及炎症因子水平的影响.方法 将120例妇科老年全麻手术患者按照随机数字表法分为观察A组、观察B组和对照组各40例,在麻醉诱导前给予观察A组右美托咪定0.8 μg·kg^-1·h^-1静脉滴注,观察B组右美托咪定0.4 μg·kg^-1·h^-1静脉滴注,给予对照组等量生理盐水静脉滴注.比较3组患者连线测验与简易精神状态检查量表评分,比较手术前后炎症因子水平变化情况. 结果 手术后观察A组连线测验与简易精神状态检查量表评分与手术前比较差异无统计学意义（P〉0.05）,观察B组与对照组评分与手术前比较差异有统计学意义（P〈0.01）,观察A组及观察B组评分均显著优于对照组（P〈0.05或0.01）,观察A组评分显著优于观察B组（P〈0.01）.手术后3组白细胞介素、血清C-反应蛋白、肿瘤坏死因子α水平均显著高于手术前（P〈0.01）,观察A组与观察B组上升幅度显著低于对照组（P〈0.05或0.01）,观察A组上升幅度显著低于观察B组（P〈0.05）.结论 在妇科老年全麻手术中应用右美托咪定可有效改善患者术后认知功能,降低机体炎症因子水平,大剂量右美托咪定有助于增强此效果.Objective To explore the effects of dexmedetomidine on post-operative cognitive function and inflammatory factors levels of senile gynecological patients undergoing general anesthesia （GA）.Methods A total of 120 senile gynecological patients undergoing GA were divided into observation A, B and control group of 40 ones each according to random number table, before anesthesia induction observation A received intravenous infusion of dexmedetomidine 0.8 μg/ kg/h, B did that 0.4 μg/kg/h, and control group did equivalent physiological saline.Trail Making Test （TMT） and Mini-mental State Examination （MMSE） scores as well as pre-and post-operative changes of inflammatory factors levels were compared among 3 groups.Results The TMT and MMSE score had no significant differences between pre-and post-operation in observation A （P〉0.05）, had in B and control group （P〈0.01）, were significantly better in A and B than in control group （P〈0.05 or 0.01）, and so were those in A than in B （P〈0.01）.Post-operative IL-6, CRP and TNF-α levels of 3 groups were significantly higher compared with pre-operation （P〈0.01）, their elevation ranges were significantly lower in A and B than in control group （P〈0.05 or 0.01）, and so were those in A than in B （P〈0.05）.Conclusion Dexmedetomidine application in senile gynecological patients undergoing GA could effectively improve postoperative cognitive functions, reduce the levels of inflammatory factors, and the increase of dexmedetomidine dosage is conduce to enhancement of this result.

关 键 词：老年 全麻手术 右美托咪定 认知功能 炎症因子 

分 类 号：R614.2[医药卫生—麻醉学]