右美托咪定辅助腰硬阻滞麻醉对老年股骨粗隆间骨折患者应激反应及认知功能的影响  

Effects of dexmedetomidine-assisted spinal epidural block anesthesia on stress response and cognitive function in elderly patients with intertrochanteric fracture

作　　者：洪晓雅 姚斌 李洋洋 HONG Xiaoya;YAO Bin;LI Yangyang(Anesthesiology Department,the Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University,Huai'an 223300,China;Intensive Care Unit Department,the Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University,Huai'an 223300,China)

机构地区：[1]南京医科大学附属淮安第一医院麻醉科,江苏淮安223300 [2]南京医科大学附属淮安第一医院重症医学科,江苏淮安223300

出　　处：《临床医学研究与实践》2023年第23期21-24,共4页Clinical Research and Practice

基　　金：南京医科大学科技发展基金一般项目(No.NMUB2020144)。

摘　　要：目的探讨右美托咪定辅助腰硬阻滞麻醉在老年股骨粗隆间骨折患者中的应用效果。方法将我院2020年1月至12月收治的60例老年股骨粗隆间骨折患者以随机数字表法分为常规组(30例,腰硬阻滞麻醉)和观察组(30例,右美托咪定辅助腰硬阻滞麻醉)。比较两组的麻醉效果。结果手术10 min时(T_(2))~术后30 min时(T_(5)),观察组的心率(HR)、呼吸(R)、血氧饱和度(SpO_(2))、平均动脉压(MAP)、中心静脉压(CVP)均高于常规组(P<0.05)。术后,观察组的神经肽Y(NPY)、β-内啡肽(β-EP)、前列腺素E_(2)(PGE_(2))、5-羟色胺(5-HT)及皮质醇(Cor)水平均低于常规组(P<0.05)。术后1、3、7 d,观察组的简易精神状态量表(MMSE)评分均高于常规组(P<0.05)。观察组的不良反应总发生率及认知功能障碍发生率均低于常规组(P<0.05)。结论对老年股骨粗隆间骨折患者采取右美托咪定辅助腰硬阻滞麻醉可取得理想的麻醉效果。Objective To explore the application effect of dexmedetomidine-assisted spinal epidural block anesthesia in elderly patients with intertrochanteric fracture.Methods Sixty elderly patients with intertrocha-nteric fracture admitted in our hospital from January to December 2020 were divided into conventional group(30 cases,spinal epidural block anesthesia)and observation group(30 cases,dexmedetomidine-assisted spinal epidural block anesthesia).The anesthesia effects of the two groups were compared.Results From 10 min of operation(T_(2))to 30 min after operation(T_(5)),the heart rate(HR),respiration(R),blood oxygen saturation(SpO_(2)),mean arterial pressure(MAP)and central venous pressure(CVP)in the observation group were higher than those in the conventional group(P<0.05).After operation,the levels of neuropeptide Y(NPY),beta-endorphin(β-EP),prostaglandin E_(2)(PGE_(2)),5-hydroxytryptamine(5-HT)and cortisol(Cor)in the observation group were lower than those in the conventional group(P<0.05).On the 1,3 and 7 d after operation,the Mini-Mental State Examination(MMSE)score of the observation group was higher than that of the conventional group(P<0.05).The total incidence of adverse reactions and the incidence of cognitive dysfunction in the observation group were lower than those in the conventional group(P<0.05).Conclusion Dexmedetomidine-assisted spinal epidural block anesthesia for elderly patients with intertrochanteric fracture can achieve ideal anesthesia effect.

关 键 词：股骨粗隆间骨折 腰硬阻滞麻醉 右美托咪定 

分 类 号：R971[医药卫生—药品]