右美托咪定对老年上腹部全身麻醉手术后认知功能障碍的影响  

Effects of dexmedetomidine on cognitive dysfunction after abdominal general anesthesia in elderly patients

作　　者：王道俊 张文学 WANG Daojun;ZHANG Wenxue(Surgical ICU,Central Hospital of Kaifeng,Kaifeng,Henan 475000,China)

机构地区：[1]河南省开封市中心医院外科ICU,河南开封475000

出　　处：《中国医学工程》2020年第3期40-42,共3页China Medical Engineering

摘　　要：目的探讨老年上腹部手术实施右美托咪定全身麻醉后对患者认知功能障碍的影响。方法根据随机数字表法将该院2018年2月至2019年3月收治的择期行上腹部手术的48例老年患者作为研究对象分为对照组(n=24例)和观察组(n=24例),两组患者均采用相同的麻醉诱导方式,观察组患者在麻醉诱导前予以右美托咪定持续泵注。观察两组患者相关炎症因子水平、简易智能量表(MMSE)评分、认知障碍发生率及总不良反应发生率。结果两组患者术后白细胞介素6(IL-6)、血中性粒细胞(NF-κB)、血清高迁移率族蛋白1(HMGB1)水平较术前升高,且观察组上述相关指标较对照组升高明显(P<0.05);术后1 d、3 d两组患者MMSE评分较术前降低且对照组降低明显(P<0.05),两组患者术后7 d MMSE评分与术前比较无统计学差异(P>0.05);观察组患者术后认知障碍发生率(12.50%)较对照组术后认知障碍发生率(45.83%)低(P<0.05);两组患者不良反应总发生率比较差异无统计学意义(P>0.05)。结论对老年上腹部手术实施右美托咪定全身麻醉可改善患者认知功能、降低术后认知障碍发生率,安全性高。【Objective】To investigate the effect of dexmedetomidine general anesthesia on cognitive dysfunction in elderly patients undergoing upper abdominal surgery.【Methods】Forty-eight elderly patients admitted to our hospital from February 2018 to March 2019 for elective abdominal surgery were selected as the research objects,and they were divided into control group(n=24 cases)and observation group(n=24)according to random number table method.Two groups of patients were treated in the same way of anesthesia induction,and patients in the observation group were given continuous pumping of dexmedetomidine before anesthesia induction.The levels of relevant inflammatory factors,simple intelligence scale(MMSE)score,incidence of cognitive impairment and incidence of total adverse reactions in the two groups were observed.【Results】The postoperative levels of interleukin 6(IL-6),neutrophils(NF-κB),and serum high mobility group protein B1(HMGB1)of the two groups were higher than those before surgery,and the above indicators in the observation group were significantly higher than those in the control group(P<0.05).The MMSE score of patients in the two groups decreased significantly on day 1 and day 3 after operation compared with that before operation(P<0.05),and there was no significant difference in MMSE score on day 7 after operation and that before operation(P>0.05).The incidence of postoperative cognitive impairment in the observation group(12.50%)was lower than that in the control group(45.83%)(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).【Conclusion】Dexmedetomidine general anesthesia for elderly patients with upper abdominal surgery can improve cognitive function,reduce the incidence of postoperative cognitive impairment and improve safety.

关 键 词：右美托咪定 认知功能障碍 全身麻醉 老年 

分 类 号：R614.2[医药卫生—麻醉学]