穴位注射右美托咪定对老年患者术后谵妄及认知功能的影响  

Effect of acupoint injection of dexmedetomidine on postoperative delirium and cognitive function in elderly patients

作　　者：田志强[1] 张许霞[1] 张洪亮[1] 孙景存[1] 刘亚君[1] 耿浩洋 井郁陌[1] TIAN Zhiqiang;ZHANG Xuxia;ZHANG Hongliang;SUN Jingcun;LIU Yajun;GENG Haoxiang;JING Yumo(Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Cangzhou 061000,Hebei,China)

机构地区：[1]河北省沧州中西医结合医院,河北沧州061000

出　　处：《现代中西医结合杂志》2020年第28期3114-3118,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：河北省沧州市重点研发指导项目(172302008)。

摘　　要：目的探讨穴位注射右美托咪定对老年患者术后谵妄、认知功能及疼痛的影响。方法选取2018年7月—2019年9月在沧州中西医结合医院手术治疗的老年患者64例,随机分为对照组和观察组各32例,观察组麻醉开始前取两侧神门穴注射右美托咪定,对照组患者则静脉注射相同剂量右美托咪定,统计2组患者术后第1,2,3天谵妄发生率,比较2组术中出血量、手术时间、复苏时间、不良反应发生情况、自控镇痛泵使用情况、简易智力状态检查量表(MMSE)评分、匹兹堡睡眠质量指数问卷(PSQI)评分、疼痛VAS评分。结果2组术后第1天谵妄发生率比较差异无统计学意义(P>0.05),术后第2天和第3天2组谵妄发生率均明显增高(P均<0.05),且对照组明显高于观察组(P均<0.05);2组患者术中出血量、手术时间以及复苏时间比较差异均无统计学意义(P均>0.05),观察组低血压、心动过缓发生率明显低于对照组(P均<0.05);2组患者术后随着时间延长镇痛泵总按压次数、有效按压次数以及用药量都随之明显增加(P均<0.05),但观察组各时间点总按压次数、有效按压次数以及用药量均明显少于对照组(P均<0.05)。术后2组患者MMSE评分均有明显下降(P均<0.05),对照组下降幅度明显高于观察组(P<0.05);观察组PSQI评分较术前明显下降(P<0.05),对照组PSQI评分无明显变化甚至略有升高(P>0.05);观察组术后静息及咳嗽VAS评分均明显低于对照组(P均<0.05)。结论穴位注射右美托咪定可明显降低老年手术患者术后谵妄发生率,缓解疼痛,促进患者早期恢复。Objective It is to investigate the effect of acupoint injection of dexmedetomidine on postoperative delirium,cognitive function and pain in elderly patients.Methods 64 elderly patients undergoing operation in Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine from July 2018 to September 2019 were randomly divided into control group and observation group,with 32 cases in each group.The patients in the observation group were treated with acupoint injection at Shenmen points at both side before anesthesia,the patients in the control group were given the same dose of dexmedetomidine by intravous injection.The incidence of delirium on the first 1,2,and 3 days after the operation of the two groups was calculated.The intraoperative blood loss,operation time,resuscitation time,occurrence of adverse reactions,use of self-controlled analgesia pumps,Mini Mental State Examination Scale(MMSE)score,Pittsburgh Sleep Quality Questionnaire Index(PSQI)score,pain VAS score were compared between the two groups.Results There was no significant difference in the incidence of delirium on the first postoperative day between the two groups(P>0.05).The incidences of delirium on the second and third days after surgery were increased significantly in both groups(P<0.05),the increase in the control group was more significant than that in the observation group(P<0.05);there was no significant difference in the intraoperative blood loss,operation time and resuscitation time between the observation and the control group(P>0.05),but the incidence of hypotension and bradycardia in the observation group was significantly lower than that in the control group(P<0.05).The total times of compressions,times of effective compressions,and medication dosage of the analgesic pump were increased significantly with time increase in the two groups after surgery(P<0.05),but the total times of compressions,times of effective compressions,and medication dosage at each time point in the observation group were significantly less than those in

关 键 词：穴位注射 右美托咪定 老年人 谵妄 

分 类 号：R971.2[医药卫生—药品]