盐酸右美托咪定对老年患者手术后早期认知功能的影响及作用机制  

Effect of Dexmedetomidine Hydrochloride on the Early Cognitive Function of Senile Patients after Surgery and Functional Mechanism

作　　者：王洋[1] 杨海涛[1] WANG Yang;YANG Hai-tao(Department of Anesthesia, Second Affiliated Hospital of Dalian Medical University,Dalian,Liaoning Province, 116027 China)

机构地区：[1]大连医科大学附属第二医院麻醉科,辽宁大连116027

出　　处：《系统医学》2018年第2期22-24,共3页Systems Medicine

摘　　要：目的分析对接受手术治疗的老年患者应用盐酸右美托咪定的临床效果。方法选择2016年11月—2017年10月该院老年手术患者78例,依据麻醉中用药分为观察组、对照组,观察组全麻诱导前应用盐酸右美托咪定,对照组在全麻诱导前给予等量的0.9%氯化钠溶液,比较两组效果。结果观察组术后早期认知功能障碍发生率为7.69%,对照组发生率为25.64%(χ~2=4.523 1,P=0.033 4);观察组术后1 d以及3 d认知功能评分为(26.37±1.39)分、(25.68±1.08)分,对照组分别为(23.48±1.89)分、(21.95±2.67)分差异有统计学意义(t=7.692 8、8.087 8,P=0.0000、0.000 0)。结论针对接受手术治疗的老年患者,在全麻诱导前给予盐酸右美托咪定能够缓解术后早期认知功能减低,同时不会对麻醉诱导期血流动力学稳定性形成严重影响,安全性有保障,可在临床推广。Objective To analyze the clinical effect of dexmedetomidine hydrochloride on the early cognitive function of senile patients after surgery and functional mechanism. Methods 78 cases of senile operative patients in our hospital from November 2016 to October 2017 were selected and divided into two groups according to the anesthesia medication, and the observation group used the dexmedetomidine hydrochloride before general anesthesia induction, while the control group used the equal amount of 0.9% sodium chloride solution before general anesthesia induction, and the effect was compared between the two groups. Results The incidence rate of cognitive function disorder in the early stage after surgery in the observation group and in the control group was respectively 7.69% and 25.64%（χ~2=4.523 1,P=0.0334）; and the cognitive function scores in 1 and 3 after surgery in the observation group and in the control group were respectively（26.37±1.39）points,（25.68±1.08）points and（23.48±1.89）points,（21.95±2.67）points the difference was statistically significant（t=7.692 8,8.087 8,P=0.000 0,0.000 0）. Conclusion The dexmedetomidine hydrochloride of senile operative patients before general anesthesia induction can relieve the postoperative early cognitive impairment, without seriously affecting the stability of hemodynamics during the general anesthesia induction, and the safety is high, which can be promoted in clinic.

关 键 词：手术 老年患者 盐酸右美托咪定 早期认知功能 作用机制 

分 类 号：R657[医药卫生—外科学]