比较不同剂量右美托咪定对老年髋关节置换术患者的肾功能、神经功能及认知功能的影响  

Compare the Effect of Different Doses of Dexmedetomidine for Renal Function,Neurological Function and Cognitive Function of Elderly Patients with Hip Replacement

作　　者：刘全成[1] LIU Quancheng(Jiamusi Central Hospital,Jiamusi 154002,China)

机构地区：[1]黑龙江省佳木斯市中心医院,黑龙江佳木斯154002

出　　处：《中国医学创新》2021年第16期58-62,共5页Medical Innovation of China

基　　金：黑龙江省卫生健康委科研课题(2019-343)。

摘　　要：目的:探究与比较不同剂量右美托咪定对老年髋关节置换术患者的肾功能、神经功能及认知功能的影响。方法:选取2017年6月-2020年1月90例老年髋关节置换术患者,将其随机分为A、B、C三组,每组30例。三组术中均采用右美托咪定治疗,A、B、C三组剂量分别为0.5、1.0、1.5μg/(kg·h)。比较三组术后的认知功能状态(MMSE评分)、不良反应发生情况及手术前后的肾功能指标、神经功能指标、认知功能指标及炎性因子。结果:术后B、C组的认知功能状态均优于A组,差异均有统计学意义(P<0.05),B组与C组比较,差异无统计学意义(P>0.05)。术前,三组的肾功能、神经功能、认知功能指标及炎性因子比较,差异均无统计学意义(P>0.05);术后24、48 h,B、C组的肾功能、神经功能、认知功能指标及炎性因子均低于A组,差异均有统计学意义(P<0.05),而B组与C组比较,差异均无统计学意义(P>0.05)。A、B组的不良反应发生率均低于C组,差异均有统计学意义(P<0.05),A组与B组比较,差异无统计学意义(P>0.05)。结论:1.0μg/(kg·h)右美托咪定在对老年髋关节置换术患者的肾功能、神经功能及认知功能的影响相对更好,且不良反应较小,因此本剂量的应用价值较高。Objective:To investigate and compare the effect of different doses of Dexmedetomidine for renal function,neurological function and cognitive function of elderly patients with hip replacement.Method:A total of 90 elderly patients with hip replacement from June 2017 to January 2020 were chosen,and they were randomly divided into group A,B,C,30 cases in each group.All three groups were treated with Dexmedetomidine 0.5,1.0,1.5μg/(kg·h)during the surgery for group A,B and C,respectively.The postoperative cognitive function status(MMSE scores),the incidence of adverse reactions were compared among the three groups,renal function indexes,neurological function indexes,cognitive function indexes and inflammatory factors before and after surgery were compared among the three groups.Result:Postoperative cognitive function status of group B and C were superior than that of group A,with statistical significance(P<0.05),there was no significant difference between group B and group C(P>0.05).There were no significant differences in renal function,neurological function,cognitive function and inflammatory factors of three groups before surgery(P>0.05);24 and 48 h after surgery,renal function,neurological function,cognitive function indexes and inflammatory factors of group B and C were lower than those of group A,with statistical significance(P<0.05),while there was no statistical significance between group B and group C(P>0.05).The incidences of ADR of group A and B were lower than that of group C,with statistical significance(P<0.05),there was no significant difference between group A and group B(P>0.05).Conclusion:The influence of 1.0μg/(kg·h)Dexmedetomidine for renal function,neurological function and cognitive function of elderly patients with hip replacement are relatively better,and the adverse reactions is less,so the application value of this dose is higher.

关 键 词：右美托咪定 剂量 老年髋关节置换术 肾功能 神经功能 认知功能 

分 类 号：R614[医药卫生—麻醉学]