右美托咪定联合复合保温措施对经尿道前列腺电切术后老年患者应激、低温性寒战及认知功能的影响  

Effect of Dexmedetomidine Combined with Composite Thermal Insulation on Post-Operative Stress Response,Hypothermic Chills and Cognitive Function in Elderly Patients Undergoing Trans-Urethral Resection Prostate

作　　者：施莉莉 梁榕[1] 李琼[1] SHI Lili;LIANG Rong;LI Qiong(The Second Affiliated Hospital of Guangxi Medical University,Nanning,Guangxi,China 530000)

机构地区：[1]广西医科大学第二附属医院,广西南宁530000

出　　处：《中国药业》2023年第15期89-93,共5页China Pharmaceuticals

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题[Z20211252]。

摘　　要：目的探讨右美托咪定联合复合保温措施对经尿道前列腺电切术(TURP)术后老年患者应激、低温性寒战及认知功能的影响。方法选取医院2021年7月至2022年6月行TURP的老年良性前列腺增生(BPH)患者60例,按简单随机分组法分为观察组和对照组,各30例。两组患者均予右美托咪定联合丙泊酚复合麻醉及常规被服保温措施,观察组加用术中加温、充气式加温系统复合保温措施。结果两组患者手术时间、术中出血量、术中输液量均无显著差异(P>0.05),观察组术后下床活动时间显著短于对照组(P<0.05);观察组手术开始后30 min、术毕、术后2 h颈内静脉血氧饱和度(SjvO_(2))、颈内静脉血氧分压(PjvO_(2))、颈内静脉血氧含量(CjvO_(2))均显著高于对照组(P<0.05);观察组术中低体温及术后2 h内低温性寒战发生率显著低于对照组(P<0.05),且程度显著轻于对照组(P<0.05);两组术后24 h血清皮质醇(Cor)、肾上腺素(AD)、促肾上腺皮质激素(ACTH)水平均较术前显著提高(P<0.05),但观察组显著低于对照组(P<0.05);两组术后48 h简易智力状态检查(MMSE)量表评分均较术前显著降低(P<0.05),但观察组显著高于对照组(P<0.05);观察组认知功能障碍发生率为6.67%,显著低于对照组的16.67%(P<0.05)。结论右美托咪定联合复合保温措施可降低TURP术后老年患者应激及低温性寒战的发生率,改善脑氧代谢,减少术后早期认识功能障碍的发生。Objective To investigate the effect of dexmedetomidine combined with composite thermal insulation on post-operative stress response,hypothermic chills and cognitive function in elderly patients undergoing trans-urethral resection prostate(TURP).Methods A total of 60 patients with benign prostatic hyperplasia(BPH)who underwent TURP in the hospital were selected and randomly divided into the observation group and the control group,with 30 cases in each group.The patients in the two groups were treated with dexmedetomidine,and propofol combined anesthesia and routine clothing thermal insulation,on this basis,the patients in the observation group were treated with intraoperative heating and inflatable heating system combined insulation measures.Results There were no significant differences in operative time,intraoperative blood loss,and intraoperative infusion volume between the two groups(P>0.05),while the postoperative ambulation time in the observation group was shorter than that in the control group(P<0.05).The internal cervical venous oxygen saturation(SjvO_(2)),internal cervical venous oxygen partial pressure(PjvO_(2)),and internal cervical venous oxygen content(CjvO_(2))in the observation group were higher than those in the control group at 30 min after operation,at the end of operation and 2 h after operation(P<0.05).The incidence of intraoperative hypothermia and hypothermic chills within 2 h after operation in the observation group was lower than that in the control group(P<0.05),and the degree in the observation group was lighter than that in the control group(P<0.05).The levels of serum cortisol(Cor),adrenaline(AD)and adrenocorticotropic hormone(ACTH)at 24 h after operation in the two groups were significantly higher than those before operation(P<0.05),but those in the observation group were significantly lower than those in the control group(P<0.05).The score of the Mini-Mental State Examination(MMSE)at 48 h after operation in the two groups was significantly lower than that before operation(P<0.05),but

关 键 词：右美托咪定 复合保温 老年 经尿道前列腺电切术 应激反应 低温性寒战 认知功能 

分 类 号：R614[医药卫生—麻醉学]