维持剂量右美托咪定对妇科手术全身麻醉患者的应用效果及机制分析  

Application Effect and Mechanism Analysis of Maintenance Dose of Dexmedetomidine in general Anesthesia for gynecological Surgery

作　　者：朱雨竹 唐明龙 李丽 张群一 赵云田[1] ZHU Yuzhu;TANG Minglong;LI Li;ZHANG Qunyi;ZHAO Yuntian(Department of Anesthesiology,Changchun Maternity Hospital,Changchun Jilin 130000,China;Department of Cardiology,First Hospital of Jilin University,Changchun Jilin 130000,China)

机构地区：[1]长春市妇产医院麻醉科,吉林长春130000 [2]吉林大学第一医院心内科,吉林长春130000

出　　处：《临床研究》2021年第6期37-38,共2页Clinical Research

摘　　要：目的探讨维持剂量右美托咪定对妇科手术全身麻醉患者的应用效果及机制。方法选取2017年11月至2020年3月在长春市妇产医院行全身麻醉后接受妇科手术的患者80例,随机数字表法分为两组,每组40例。观察组给予静脉输注右美托咪定,对照组给予静脉输注0.9%氯化钠注射液,比较两组不同时间点的高迁移率族蛋白B1(HMGB1)、神经元特异性烯醇化酶(NSE)、MMSE评分及术后7 d的认知功能障碍。结果术毕、术后1 d~7 d时,两组的HMGB1、NSE水平明显升高,而同时间点观察组明显低于对照组;术后1 d及术后3 d时,观察组患者的MMSE评分低于对照组;观察组患者的认知功能障碍发生率明显低于对照组(P<0.05)。结论维持剂量右美托咪定可降低妇科手术全身麻醉患者中的术后认知功能障碍发生率,可能与其可降低患者的HMGB1、NSE水平有关。Objective To investigate the effect and mechanism of maintenance dose dexmedetomidine in general anesthesia patients undergoing gynecological surgery.Methods From November 2017 to March 2020,80 patients who underwent gynecological surgery after general anesthesia in Changchun Maternity Hospital were randomly divided into two groups,40 cases in each group.The observation group was given intravenous infusion of Dexmedetomidine,while the control group was given intravenous infusion of 0.9%sodium chloride injection,HMGB1,NSE,MMSE score and cognitive impairment 7 days after operation were compared between the two groups.Results The levels of HMGB1 and NSE in the two groups were significantly increased after operation and 1-7 days after operation,while the MMSE score and NSE in the observation group was significantly lower than that in the control group at the same time point,and the MMSE score in the observation group was significantly lower than that in the control group at the 1st and 3rd days after operation.The incidence of cognitive dysfunction in the observation group was significantly lower than that in the control group(P<0.05).Conclusion Maintenance dose of Dexmedetomidine can reduce the incidence of postoperative cognitive dysfunction in patients undergoing gynecological surgery under general anesthesia,which may be related to the decrease of HMGB1 and NSE levels.

关 键 词：右美托咪定 全身麻醉 认知功能障碍 HMGB1 NSE 

分 类 号：R614[医药卫生—麻醉学]