右美托咪定对颈动脉内膜剥脱术老年患者术后认知功能的影响  

Effect of dexmedetomidine on postoperative cognitive function of elderly patients undergoing carotid endarterectomy

作　　者：李颖[1] 刘亚庆 LI Ying;LIU Ya-qing(Department of Anesthesia,Dalian Central Hospital,Dalian 116033,China)

机构地区：[1]大连市中心医院麻醉科,116033 [2]大连医科大学附属第二医院急腹症外科,116023

出　　处：《中国现代药物应用》2020年第19期141-143,共3页Chinese Journal of Modern Drug Application

摘　　要：目的研究右美托咪定对颈动脉内膜剥脱术(CEA)老年患者术后认知功能的影响。方法100例行CEA的老年患者,随机分为对比组和观察组,每组50例。对比组患者实施常规麻醉,观察组患者实施右美托咪定麻醉。比较两组患者术后认知功能、术后认知功能障碍(POCD)发生情况及血清S100β蛋白和神经元特异性烯醇化酶(NSE)水平。结果术后2、12、24 h,观察组患者简易精神状态量表(MMSE)评分分别为(22.54±0.50)、(26.45±0.70)、(27.34±1.12)分,均高于对比组的(21.40±0.38)、(24.81±0.56)、(26.40±1.00)分,差异有统计学意义(P<0.05)。术后2、12 h,观察组POCD发生率为6.00%(3/50)、4.00%(2/50),均低于对比组的22.00%(11/50)、16.00%(8/50),差异具有统计学意义(χ^2=5.316、4.000,P=0.021、0.046<0.05);术后24 h,观察组POCD发生率为2.00%(1/50),与对比组的8.00%(4/50)比较差异无统计学意义(χ^2=1.895,P=0.169>0.05)。术后2、12 h,观察组患者血清S100β蛋白和NSE水平均低于对比组,差异具有统计学意义(P<0.05)。结论老年患者CEA中应用右美托咪定麻醉,可显著预防POCD。Objective To study the effect of dexmedetomidine on postoperative cognitive function of elderly patients undergoing carotid endarterectomy(CEA).Methods A total of 100 elderly patients with CEA were randomly divided into control group and observation group,with 50 cases in each group.Patients in the comparison group received conventional anesthesia,and patients in the observation group received conventional anesthesia combined with dexmedetomidine anesthesia.The postoperative cognitive function,occurrence of postoperative cognitive dysfunction(POCD)and serum S100βprotein and neuron-specific enolase(NSE)levels were compared between the two groups.Results 2,12 and 24 h after operation,mini-mental state examination(MMSE)score of the observation group were(22.54±0.50),(26.45±0.70)and(27.34±1.12)points,which were higher than(21.40±0.38),(24.81±0.56)and(26.40±1.00)points of the control group,and the difference was statistically significant(P<0.05).2 and 12 h after operation,the incidence of POCD of the observation group were 6.00%(3/50)and 4.00%(2/50),which were lower than 22.00%(11/50)and 16.00%(8/50)of the control group,and the difference was statistically significant(χ^2=5.316,4.000,P=0.021,0.046<0.05).24 h after operation,the incidence of POCD of the observation group was 2.00%(1/50),which had no statistically significant difference compared with 8.00%(4/50)of the control group(χ^2=1.895,P=0.169>0.05).2 and 12 h after operation,serum S100βprotein and NSE level of the observation group were lower than those of the control group,and the difference was statistically significant(P<0.05).Conclusion Dexmedetomidine anesthesia in CEA can significantly prevent POCD in elderly patients.

关 键 词：颈动脉内膜剥脱术 右美托咪定 常规麻醉 老年患者 术后认知 

分 类 号：R614[医药卫生—麻醉学]