右美托咪定对老年患者全身麻醉术后认知功能障碍的影响  

Effect of Dexmedetomidine on postoperative cognitive dysfunction in elderly patients after general anesthesia

作　　者：吴小琴 夏克江 WU Xiaoqin;XIA kejiang(Department of Anaesthesiology,Yingtan City People's Hospital,Jiangxi Province,Yingtan 335000,China)

机构地区：[1]江西省鹰潭市人民医院麻醉科,江西鹰潭335000

出　　处：《中国当代医药》2025年第1期59-62,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202140650)。

摘　　要：目的探讨右美托咪定对预防全身麻醉术后老年患者认知障碍(POCD)的效果。方法选取2021年6月至2023年12月鹰潭市人民医院收治的80例老年患者作为研究对象,采用随机数字表法分为观察组和对照组,每组40例。所有患者均接受对症手术治疗,麻醉方法均为全身麻醉,观察组患者在手术麻醉的基础上采用右美托咪定,对照组患者给予同等剂量与输注速度的生理盐水,比较两组患者的麻醉指标、体征变化、炎症因子水平、POCD和不良事件发生情况。结果两组患者的麻醉时间比较,差异无统计学意义(P>0.05)。观察组的清醒时间、拔管时间均短于对照组,差异有统计学意义(P<0.05)。手术后,观察组的心率、平均动脉压、血氧饱和度均高于对照组,差异有统计学意义(P<0.05)。手术后,观察组的白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、去甲肾上腺素(NE)水平均低于对照组,差异有统计学意义(P<0.05)。观察组的POCD发生率低于对照组,差异有统计学意义(P<0.05)。两组的不良事件总发生率比较,差异无统计学意义(P>0.05)。结论在老年患者全身麻醉术中应用右美托咪定有利于稳定患者围手术期体征,减轻其机体的炎症反应,降低POCD的发生风险,值得运用推广。Objective To explore the effect of Dexmedetomidine on postoperative cognitive dysfunction(POCD)after general anesthesia.Methods A total of 80 elderly patients admitted to Yingtan City People's Hospital from June 2021 to December 2023 were selected as the study objects and they were divided into observation group and control group according to random number table method,with 40 cases in each group.All patients received surgical treatment in hospital with general anesthesia.Observation group received Dexmedetomidine on the basis of surgical anesthesia,while control group received normal saline with the same dose and infusion speed.Anesthetic indexes,changes in physical signs,levels of inflammatory factors,POCD and adverse events condition of patients in the two groups were compared.Results There was no significant difference in anesthesia duration between the two groups(P>0.05).The waking time and extubation time of the observation group were shorter than those of the control group,and the differences were statistically significant(P<0.05).After operation,the heart rate,mean arterial pressure and blood oxygen saturation of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).After operation,the levels of interleukin-6(IL-6),interleukin-10(IL-10)and norepinephrine(NE)in observation group were lower than those in control group,with statistical significances(P<0.05).The incidence of POCD in observation group was lower than that in control group,and the difference was statistically significant(P<0.05).There was no significant difference in the total incidence of adverse conditions between the two groups(P>0.05).Conclusion The application of Dexmedetomidine in general anesthesia in elderly patients is beneficial to stabilize perioperative signs,reduce the inflammatory response of the body,and reduce the risk of POCD,which is worthy of application and promotion.

关 键 词：右美托咪定 老年 全身麻醉 认知障碍 炎症反应 

分 类 号：R614.2[医药卫生—麻醉学]