右美托咪定对老年腹腔镜手术患者脑氧饱和度及术后认知功能的影响  

Effects of Dexmedetomidine on Cerebral Oxygen Saturation and Postoperative Cognitive Function in Elderly Patients Undergoing Laparoscopic Surgery

作　　者：王凯[1] 王青 徐循 何文胜[1] 张军[1] WANG Kai;WANG Qing;XU Xun;HE Wensheng;ZHANG Jun(Department of Anesthesiology,the Second People's Hospital of Hefei,Hefei,Anhui Province,230011 China)

机构地区：[1]合肥市第二人民医院麻醉科,安徽合肥230011

出　　处：《世界复合医学》2022年第5期27-29,37,共4页World Journal of Complex Medicine

基　　金：合肥市第二人民医院2021年度青年科研基金项目(2021yqn23)。

摘　　要：目的分析右美托咪定对老年腹腔镜手术患者脑氧饱和度及术后认知功能的影响。方法选取合肥市第二人民医院2020年9月—2021年10月60例接受腹腔镜手术治疗的老年患者为研究对象,按区间随机法分为观察组和对照组,每组30例。两组均采用气管插管麻醉,观察组在10 min内完成0.5μg/kg右美托咪定泵注,后续以0.3μg/(kg•h)持续注入,对照组泵注同等容量的生理盐水。对比两组患手术前后脑氧饱和度、认知功能、平均心率、血压水平。结果两组患者T0、T1、T2、T3时SctO_(2)、MAP指标对比,差异无统计学意义(P>0.05),在T2时观察组PaO_(2)、PaCO_(2)优于对照组,差异有统计学意义(P<0.05);麻醉后观察组MMES评分(28.41±1.20)分高于对照组(22.26±2.35)分,差异有统计学意义(t=12.766,P<0.05);麻醉前两组平均心率及血压水平对比,差异无统计学意义(P>0.05),麻醉后观察组指标优于对照组,差异有统计学意义(P<0.05)。结论右美托咪定不会对老年腹腔镜手术患者脑氧饱和度造成明显影响,同时可有效降低术后认知功能障碍的发生风险。Objective To analyze the effect of dexmedetomidine on cerebral oxygen saturation and postoperative cognitive function in elderly patients undergoing laparoscopic surgery.Methods From September 2020 to October 2021,60 elderly patients who received laparoscopic surgery in Hefei Second People's Hospital were selected as the research objects,and were randomly divided into observation group and control group according to interval method,30 cases in each group.Both groups were anesthetized by endotracheal intubation.The observation group was injected with 0.5μg/kg dexmedetomidine within 10 min,and then continuously injected at 0.3μg/(kg·h).The control group was injected with the same volume of normal saline.The levels of cerebral oxygen saturation,cognitive function,average heart rate,and blood pressure were compared between the two groups before and after surgery.Results There was no statistically significant difference in SctO_(2)and MAP indexes in T0,T1,T2 and T3 indexes between the two groups(P>0.05).At T2,PaO_(2)and PaCO_(2)in the observation group were better than those in the control group,and the difference was statistically significant(P<0.05).After anesthesia,the MMES score of the observation group(28.41±1.20)points was higher than that of the control group(22.26±2.35)points,and the difference was statistically significant(t=12.766,P<0.05).Before anesthesia,the mean heart rate and blood pressure levels between the two groups were not statistically significant(P>0.05).After anesthesia,the indexes in the observation group were better than those in the control group,and the difference was statistically significant(P<0.05).Conclusion Dexmedetomidine does not significantly affect cerebral oxygen saturation in elderly patients with laparoscopic surgery,and can effectively reduce the risk of postoperative cognitive dysfunction.

关 键 词：腹腔镜手术 认知功能 右美托咪定 脑氧饱和度 

分 类 号：R574[医药卫生—消化系统]