右旋美托咪啶对中老年肺癌根治术患者术后认知功能的影响  

Effect of dexmedetomidine on postoperative cognitive function in elderly patients with lung cancer undergoing radical resection

作　　者：刘艳萍[1] 于婵娟[1] 刘亚华[1] Yanping LIU;Chanjuan YU;Yahua LIU(Department of Anesthesiology, Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi 830011, China)

机构地区：[1]新疆医科大学附属肿瘤医院麻醉科,新疆乌鲁木齐830011

出　　处：《临床检验杂志（电子版）》2017年第2期179-180,共2页Clinical Laboratory Journal(Electronic Edition)

基　　金：新疆维吾尔自治区自然科学基金面上项目(No.2014211C107)

摘　　要：目的观察右旋美托咪啶对中老年肺癌根治术患者术后认知功能的影响。方法 80例在全身麻醉双腔支气管插管下择期行肺癌根治术的患者随机分为对照组(C组)和右旋美托咪啶组(D组),C组患者采用丙泊酚+舒芬太尼+顺式阿曲库铵的常规诱导方式,诱导完全后,插入双腔支气管导管,D组采用1μg/mL右旋美托咪定术前30 min开始持续泵注,麻醉诱导与气管插管方式与对照组相同。观察两组患者7项认知功能于手术前、术后3 d和7 d的测评情况。7项测试项目中至少2项,单项测试值低于基础值20%以上者,确认为认知功能损害。结果 80例病人术后3 d和7 d认知功能的发生率分别为63.2%和41.3%。年龄与术后认知功能测试项目中的视觉再生(r=-0.47)和钉板试验(r=-0.47)有相关关系。结论中老年患者行创伤较大的手术,特别是高龄病人早期存在认知功能紊乱,应当引起临床医师的足够重视。右美托咪定对中老年患者术后早期的认知功能紊乱有一定的预防作用。Objective To observe the effect of dexmedetomidine on postoperative cognitive function in elderlypatients with lung cancer after radical resection.Methods80patients who underwent radical resection of lung cancer undergeneral anesthesia and double lumen endobronchial intubation were randomly divided into two groups:control group(groupC)and dexmedetomidine(group D).Patients in group C received conventional induction of propofol+sufentanil+CIS atracurium,and were completely inserted into the double lumen endobronchial tube after induction.In group D,1μg/mL dexmedetomidinewas used to start continuous pump infusion at30min before operation.Anesthesia induction and tracheal intubationwere the same as those in the control group.The7cognitive functions of the two groups were evaluated before operation,3d and7d after operation.Results The incidence of cognitive function was63.2%and41.3%in80patients after3d and7d,respectively.Age was related to visual regeneration(r=-0.47)and nail plate test(r=-0.47)in the postoperative cognitive functiontest program.Conclusion In elderly patients with severe trauma surgery,especially in elderly patients with early cognitivedysfunction,clinicians should pay enough attention to them.Dexmedetomidine has a preventive effect on early postoperativecognitive dysfunction in elderly patients.

关 键 词：右旋美托咪啶 认知功能障碍 肺癌根治术 

分 类 号：R614[医药卫生—麻醉学] R734.2[医药卫生—外科学]