右美托咪定对52例气虚体质老年患者围手术期神经认知紊乱的影响  

Effect of dexmedetomidine on perioperative neurocognitive disorder in 52 elderly patients with Qi deficiency constitution

作　　者：孙婷辉 上官云芳 段思源[1] SUN Tinghui;SHANGGUAN Yunfang;DUAN Siyuan(Department of Anesthesiology,Shanghai TCM-integrated Hospital affiliated to Shanghai TCM University,Shanghai 200082,China)

机构地区：[1]上海中医药大学附属上海中西医结合医院麻醉科,上海200082

出　　处：《上海医药》2020年第11期28-30,34,共4页Shanghai Medical & Pharmaceutical Journal

摘　　要：目的 :探讨右美托咪定对气虚体质老年患者围手术期神经认知紊乱(perioperative neurocognitive disorders,PND)情况。方法 :选取106例需全麻手术患者随机分为对照组和试验组,排除7例因拒绝术后问卷调研患者后试验组52例和对照组47例,两组均按照中医体质分型分为气虚亚组和非气虚亚组,麻醉前试验组给予静脉注射右美托咪定。比较术中主要麻醉药用量和术后7 d PND发生率。结果 :试验组PND发生率显著低于对照组(19.3%vs 55.3%);两组中气虚患者的PND发生率均高于非气虚患者(P <0.05);试验组气虚亚组PND发生率显著低于对照组气虚亚组(37.5%vs 80.0%,P <0.05)。结论 :右美托咪定能降低PND发生率,且对气虚患者的神经认知紊乱亦有一定的改善能力。Objective:To investigate the effect of dexmedetomidine on the peripheral neurocognitive disorder(PND)in elderly patients with Qi deficiency constitution.Methods:One hundred and six patients undergoing general anesthesia were randomly divided into a control group(47 cases)and a test group(52 cases)except for 7 cases who refused to do questionnaire investigation.They were further divided into Qi deficiency subgroups and non-Qi deficiency subgroups according to TCM constitution.The test group was given intravenous dexmedetomidine before anesthesia.The dosage of main anesthetics during operation and the incidence of PND at 7 days after operation were compared.Results:The incidence of PND was significantly lower in the test group than the control group(19.3%vs 55.3%)and in the Qi deficiency subgroup in the test group than the Qi deficiency subgroup in the control group(37.5%vs 80.0%,P<0.05).The incidence of PND was higher in the patients with Qi deficiency than the patients without Qi deficiency(P<0.05).Conclusion:Dexmedetomidine can decrease the incidence of PND in general anesthesia and also has a certain ability to improve neurocognitive disorders in elderly patients with Qi deficiency.

关 键 词：全身麻醉 气虚体质 围手术期神经认知紊乱 右美托咪定 

分 类 号：R971.3[医药卫生—药品] R614[医药卫生—药学]