麻醉诱导前静脉滴注右美托咪定对老年术后患者认知功能及情绪的影响  

Effect of intravenous drip of dexmedetomidine before induction of anesthesia on cognitive function and mood state of elderly patients after percutaneous nephrolithotomy

作　　者：韩庆峰 张点红 万文锦[3] HAN Qingfeng;ZHANG Dianhong;WANWenjin(The Second Affiliated Hospital of Luohe Medical College,Luohe 462000,China)

机构地区：[1]漯河医学高等专科学校第二附属医院,漯河462000 [2]漯河市第一人民医院 [3]漯河市第三人民医院

出　　处：《国际精神病学杂志》2022年第3期516-518,522,共4页Journal Of International Psychiatry

摘　　要：目的探究麻醉诱导前应用右美托咪定(DEX)对老年经皮肾镜取石术老年患者的价值。方法将我科老年经皮肾镜取石术患者121例,按照随机抽签法分为常规组(n=60)和研究组(n=61),其中常规组麻醉诱导前施以等量生理盐水,研究组麻醉诱导前静脉滴注DEX,对比两组患者的手术效果,术后认知功能,心境状态及氧化应激水平。结果研究组总有效率与常规组对比差异无统计学意义(P>0.05),术后3天,1周,研究组简明智能状态量表(MMSE)水平高于常规组,重症监护谵妄筛查量表(ICDSC)水平低于常规组(P<0.05);抑郁自评量表(SDS),焦虑自评量表(SAS)评分较常规组低(P<0.05);皮质醇(Cor)和去甲肾上腺素(NE),疼痛视觉模拟量表(VAS)低于常规组(P<0.05)。结论麻醉诱导前应用DEX在预防老年经皮肾镜取石术患者术后认知功能障碍,不良情绪方面效果更佳,有效减轻疼痛和应激反应。Objective To explore the value of applying dexmedetomidine(DEX)before induction of anesthesia in elderly patients undergoing percutaneous nephrolithotomy.Methods A total of 121 elderly patients undergoing percutaneous nephrolithotomy in our department were divided into a routine group(n=60)and a study group(n=61)according to random drawing.The routine group was given the same amount of normal saline before induction of anesthesia.In the study group,DEX was injected intravenously before induction of anesthesia,and the effect of surgery,postoperative cognitive function,mood state and oxidative stress level were compared.Results The total effective rate of the study group was not statistically significant than that of the routine(P>0.05).3 days and 1 week after the operation,the level of the study group's Mini-mental State Examination(MMSE)was higher than that of the routine group.The Intensive Care Delirium Screening Scale(ICDSC)Level is lower than that of the conventional group(P<0.05).The level of Self-rating Depression Scale(SDS)and Self-rating Anxiety Scale(SAS)is lower than that of the conventional group(P<0.05).Cortisol(Cor)and norepinephrine(NE)and Pain Visual Analog Scale(VAS)were lower than those in the conventional group(P<0.05).Conclusion Application of DEX before induction of anesthesia is better in preventing postoperative cognitive dysfunction and poor mental state of elderly patients undergoing percutaneous nephrolithotomy,effectively reducing pain and stress response.

关 键 词：右美托咪定 经皮肾镜取石术 心境状态 

分 类 号：R749.2[医药卫生—神经病学与精神病学]