右美托咪定在接受腰硬联合麻醉轻度抑郁老年患者术后的应用效果  

Application effect of Dexmedetomidine on elderly patients with mild depression after combined spinal and epidural anesthesia

作　　者：田亮 李朝阳[1] 张杰[1] TIAN Liang;LI Chao-yang;ZHANG Jie(Department of Anesthesiology,Shenzhen Nanshan People′s Hospital,Guangdong Province,Shenzhen 518000,China)

机构地区：[1]深圳市南山区人民医院麻醉科

出　　处：《中国当代医药》2020年第3期138-141,共4页China Modern Medicine

摘　　要：目的探讨右美托咪定在接受腰硬联合麻醉轻度抑郁老年患者术后的应用效果。方法选取2018年5月~2019年4月我院收治的80例接受腰硬联合麻醉行下肢骨科手术治疗的轻度抑郁老年患者作为研究对象,按照随机数字表法分为对照组和试验组,每组各40例。对照组静脉滴注咪达唑仑镇静,试验组静脉滴注右美托咪定镇静。采用酶联免疫吸附试验检测并比较两组术前0.5 h(T0)、手术结束(T1)、术后6 h(T2)、术后1 d(T3)的外周静脉中神经元特异性烯醇化酶(NSE)及S100β蛋白水平;采用简易精神状态量表(MMSE)评估并比较两组术前1 d、术后1 d及术后3 d的认知功能。结果两组T0时的NSE及S100β蛋白水平比较,差异无统计学意义(P>0.05);两组T1、T2、T3时的NSE及S100β蛋白水平高于T0时,试验组T1、T2、T3时的NSE及S100β蛋白水平低于对照组,差异均有统计学意义(P<0.05)。两组术前1 d的MMSE评分比较,差异无统计学意义(P>0.05);两组术后1、3 d的MMSE评分低于术前1 d,试验组术后1、3 d的MMSE评分高于对照组,差异均有统计学意义(P<0.05)。结论采用右美托咪定镇静对接受腰硬联合麻醉的轻度抑郁老年患者,可降低患者不同时间点的NSE及S100β蛋白水平,改善患者术后的短期认知功能,值得临床推广应用。Objective To investigate the application effect of Dexmedetomidine on elderly patients with mild depression after combined spinal and epidural anesthesia.Methods A total of 80 elderly patients with mild depression who received combined spinal and epidural anesthesia for lower extremity orthopaedic surgery in our hospital from May 2018 to April 2019 were selected as the study objects,they were divided into control group and experimental group according to the random number table method,40 cases in each group.The control group was intravenously sedated by Midazolam,and the experimental group was intravenously sedated by Dexmedetomidine.The levels of neuron-specific enolase(NSE)and S100茁protein in peripheral veins of the two groups were detected and compared by enzyme-linked immunosorbent assay at 0.5 h(T0)before operation,at the end of operation(T1),at 6 h(T2)after operation and at 1 d(T3)after operation.The cognitive function of the two groups was evaluated and compared by mini-mental state examination(MMSE).Results There was no significant difference in the levels of NSE and S100β protein at T0 between the two groups(P>0.05).The levels of NSE and S100β protein at T1,T2,and T3 were higher than those at T0 in both groups,the NSE and S100β protein levels in the experimental group at T1,T2,and T3 were lower than those in the control group,the differences were statistically significant(P<0.05).There was no significant difference in MMSE scores between the two groups 1 d before surgery(P>0.05).The MMSE scores at 1 and 3 days after surgery were lower in the two groups than at 1 day before surgery,the MMSE score of the experimental group was higher than that of the control group at 1 and 3 days after operation,the differences were statistically significant(P<0.05).Conclusion Dexmedetomi-dine sedation can reduce the levels of NSE and S100-protein at different time points in elderly patients with mild depression receiving combined spinal and epidural anesthesia,which can improve the short-term cognitive function of pa

关 键 词：右美托咪定 腰硬联合麻醉 轻度抑郁 老年患者 短期认知功能 

分 类 号：R816.8[医药卫生—放射医学]