高剂量乌司他丁联合右美托咪定预防老年肠切除吻合患者术后谵妄的效果观察  

Effect of high dose ulinastatin combined with dexmedetomidinein prevention of postoperative delirium in elderly patients with intestinal resection and anastomosis

作　　者：谭剑[1] 巫志国[1] 周兵[1] TAN Jian;WU Zhiguo;ZHOU Bing(Department of Anesthesiology,the People's Hospital of Pingxiang,Pingxiang,Jiangxi,337055,China)

机构地区：[1]萍乡市人民医院麻醉科,江西萍乡337055

出　　处：《当代医学》2022年第12期59-61,共3页Contemporary Medicine

基　　金：江西省卫生健康委科技计划项目(202140527)。

摘　　要：目的探究高剂量乌司他丁联合右美托咪定预防老年肠切除吻合患者术后谵妄的效果。方法选取2019年3月至2021年1月于本院接受肠切除吻合手术的90例老年患者作为研究对象,随机分为低剂量组、高剂量组和对照组,每组30例。低剂量组给予0.5μg/kg右美托咪定+0.5×10^(4) U/kg乌司他丁+100 ml 0.9%氯化钠注射液;高剂量组给予0.5μg/kg右美托咪定+1.5×10^(4) U/kg乌司他丁+100 ml 0.9%氯化钠注射液;对照组给予100 ml 0.9%氯化钠注射液。比较3组术后谵妄发生率、苏醒时间、有效镇痛时间、住院时间、睡眠质量及术中低血压、高血压、心率缓慢发生情况。结果高剂量组术后谵妄发生率明显低于低剂量组与对照组,差异具有统计学意义(P<0.05)。3组术后苏醒时间比较差异无统计学意义;高剂量组有效镇痛时间、住院时间均短于对照组与低剂量组,睡眠质量评分低于对照组与低剂量组,差异有统计学意义(P<0.05)。高剂量组术中不良反应发生率低于低剂量组和对照组,差异有统计学意义(P<0.05)。结论高剂量乌司他丁联合右美托咪定能有效预防老年肠切除吻合患者术后谵妄的发生,值得临床推广应用。Objective To study the effect of highdose ulinastatin combined with dexmedetomidinein the prevention of postoperative delirium in elderly patients with intestinal resection and anastomosis.Methods 90 elderly patients who underwent bowel resection and anastomosis in our hospital from March 2019 to January 2021 were selected as the research subjects and they were randomly divided into lowdose group,highdose group and control group,with 30 cases in each group.The lowdose group was given 0.5μg/kg dexmedetomidine+0.5×10^(4) U/kg ulinastatin+100 ml 0.9%sodium chloride injection;the highdose group was given 0.5μg/kg dexmedetomidine+1.5×10^(4) U/kg ulinastatin+100 ml 0.9%sodium chloride injection;the control group was given 100 ml 0.9%sodium chloride injection.The incidence of postoperative delirium,recovery time,effective analgesia time,hospital stay,sleep quality,and intraoperative hypotension,hypertension,and slow heart rate were compared among the three groups.Results The incidence of postoperative delirium in the highdose group was significantly lower than that in the lowdose group and the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the postoperative recovery time among the three groups;the effective analgesia time and hospital stay in the highdose group were shorter than those in the control and lowdose groups,and the sleep quality score was lower than that in the control group and lowdose group,and the difference was statistically significant(P<0.05).The incidence of intraoperative adverse reactions in the highdose group was lower than that in the lowdose group and the control group,and the difference was statistically significant(P<0.05).Conclusion Highdose ulinastatin combined with dexmedetomidine can effectively prevent postoperative delirium in elderly patients with intestinal resection and anastomosis,it is worthy of clinical promotion and application.

关 键 词：高剂量乌司他丁 右美托咪定 老年肠切除吻合术 术后谵妄 

分 类 号：R614[医药卫生—麻醉学]