右美托咪定对中老年脑出血患者术后谵妄发生率及记忆力的影响  

The effect of dexmedetomidine on postoperative delirium incidence and memory in middle-aged and elderly patients with cerebral hemorrhage

作　　者：武庆涛[1] 张震[2] Wu Qingtao;Zhang Zhen(Shangqiu First People's Hospital,Shangqiu 476000,Henan,China)

机构地区：[1]商丘市第一人民医院,河南商丘476000 [2]河南省肿瘤医院,河南郑州450000

出　　处：《临床心身疾病杂志》2023年第5期136-139,共4页Journal of Clinical Psychosomatic Diseases

基　　金：河南省医学科技攻关计划项目(编号LHGJ20190665)。

摘　　要：目的 探讨右美托咪定对中老年脑出血患者术后谵妄发生率及记忆力的影响。方法 将116例行手术治疗的中老年脑出血患者按随机数字表法分为观察组和对照组,每组58例。术后进入重症监护室到次日清晨,观察组给予小剂量右美托咪定静脉滴注,对照组给予生理盐水静脉滴注。比较两组患者术后谵妄发生率及记忆力。结果 术后7 d,观察组谵妄发生率为1.72%,对照组为13.79%,观察组低于对照组,差异有统计学意义(P<0.05)。术后7 d观察组患者数字广度测验的顺背数字、倒背数字分测验评分均高于对照组,差异有统计学意义(P<0.05)。术后1 d、3 d观察组患者视觉模拟疼痛评分法评分均低于对照组,术后3 d两组均较术后1 d下降,差异有统计学意义(P<0.01)。结论 右美托咪定可有效降低中老年脑出血患者术后谵妄发生率,对患者记忆力影响较小。Objective To explore the effect of dexmedetomidine on postoperative delirium incidence and memory in middle-aged and elderly patients with cerebral hemorrhage(CH).Methods A total of 116 middle-aged and elderly CH patients undergoing operation were divided into observation(n=58)and control(n=58)group according to random number table method.After operation they were admitted to the intensive care unit(ICU)until the next morning,observation group received intravenous drip of dexmedetomidine,and the control did normal saline.Postoperative delirium incidence and memory were compared between two groups.Results On day 7 after surgery the incidence of delirium was lower in observation than control group(1.72%vs.13.79%)and difference statistically significant(P<0.05).On day 7 after surgery the scores on forward and backward recitation of numbers of the Digital Span Test were higher in observation than control group and differences statistically significant(P<0.05).Scores on the Visual Analogue Scale were lower in observation than control group on day 1 and 3 after surgery,those of both groups lowered on day 3 compared with day 1 after surgery,and differences were statistically significant(P<0.01).Conclusion Dexmetomidine could effectively reduce the incidence of postoperative delirium in middle-aged and elderly CH patients and has less impact on patients'memory.

关 键 词：右美托咪定 脑出血 手术 中老年患者 谵妄 记忆力 

分 类 号：R722.151[医药卫生—儿科]