不同时机输注右美托咪定对老年人术后谵妄的影响研究  

Effects of Dexmedetomidine Infusion at Different Times on Postoperative Delirium in the Elderly

作　　者：张志宇[1] 武志鹏[2] 董伟[2] ZHANG Zhi-yu;WU Zhi-peng;DONG Wei(Department of Traumatology and Orthopaedics,Shouguang People's Hospital,Shouguang,Shandong Province,262700 China;Department of Anesthesiology,Shouguang People's Hospital,Shouguang,Shandong Province,262700 China)

机构地区：[1]寿光市人民医院创伤骨科,山东寿光262700 [2]寿光市人民医院麻醉科,山东寿光262700

出　　处：《系统医学》2020年第10期29-31,共3页Systems Medicine

基　　金：山东省潍坊市卫生和计划生育委员会科研项目(wfwsjk_2019_248);山东省潍坊市卫生和计划生育委员会科研项目(2017wsjs030)。

摘　　要：目的探究不同时机输注右美托咪定对老年患者术后谵妄的影响。方法选择2018年3月—2019年4月在该院接受非心脏全麻手术的80例老年患者作为研究对象,采用信封法将其平均分为对照组和治疗A、B、C组,治疗组分别在不同时间段为患者输注右美托咪定,而对照组则在相应时间段内为患者输注生理盐水,对两组患者术后谵妄发生情况、术后24 h RASS评分和VAS评分进行观察记录,并对比临床治疗效果。结果治疗A(5.00%)、B(5.00%)组患者谵妄发生率明显低于对照组(35.00%)(P<0.05),而治疗C(10.00%)组患者与对照组相比,差异无统计学意义(χ^2=0.854,P>0.05);治疗A、B、C组患者术后24 h RASS评分分别为:(0.15±0.42)分、(0.25±0.60)分、(0.01±0.97)分和VAS评分分别为:(1.63±1.15)分、(1.41±1.14)分、(1.31±1.09)分显著低于对照组(0.93±2.14)分、(2.70±1.23)分,RASS评分:(t=6.715、9.822、6.394,P<0.05),VAS评分:(t=8.394、8.112、9.071,P<0.05)。结论术前、术中输注右美托咪定可有效减少老年患者术后谵妄的发生风险,提高镇痛镇静效果,不良反应较少,安全性相对较高。Objective To explore the effect of dexmedetomidine infusion at different times on postoperative delirium in elderly patients.Methods Eighty elderly patients who underwent non-cardiac general anesthesia surgery in the hospital from March 2018 to April 2019 were selected as the research subjects.They were divided into control group and treatment group A,B and C by envelope method.The patients in the treatment group were infused with dexmedetomidine at different time periods,while the control group was infused with saline in the corresponding time period.The incidence of delirium,the 24 h postoperative RASS score,and the VAS were given to the patients in the corresponding group.The score was observed and recorded,and the clinical treatment effect was compared.Results The incidence of delirium was significantly lower in the patients in the treatment group A(5.00%)and B(5.00%)than in the control group(35.00%)(P<0.05),while the treatment group C(10.00%),compared with the control group(χ^2=0.854,P>0.05),the difference was not statistically significant(P>0.05);after treatment,the ASS scores of patients in groups A,B,and C at 24 h RAS:(0.15±0.42)points,(0.25±0.60)points,(0.01±0.97)points,and the VAS scores(1.63±1.15)points,(1.41±1.14)points,(1.31±1.09)points,respectively were significantly lower than those in the control group(0.93±2.14)points、(2.70±1.23)points,and RASS score were(t=6.715,9.822,6.394,P<0.05),respectively.The VAS scores were(t=8.394,8.112,9.071,P<0.05).Conclusion Preoperative and intraoperative infusion of dexmedetomidine can effectively reduce the risk of postoperative delirium in elderly patients,improve the analgesic and sedative effects,have fewer adverse reactions,and have relatively high safety.

关 键 词：不同时机 右美托咪定 老年人 术后谵妄 影响 

分 类 号：R4[医药卫生—临床医学]