右美托咪定复合腰硬联合麻醉对老年股骨粗隆间骨折手术患者的影响  

Effect of Dexmedetomidine Combined with Lumbar Epidural Anesthesia on Elderly Patients with Intertrochanteric Fracture

作　　者：廖睿 Liao Rui(Department of Anesthesiology,Zhaoqing Gaoyao District People's Hospital,Zhaoqing 526000,Guangdong Province,China)

机构地区：[1]肇庆市高要区人民医院麻醉科,广东肇庆526000

出　　处：《中外医药研究》2025年第2期18-20,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

摘　　要：目的:探究右美托咪定复合腰硬联合麻醉对老年股骨粗隆间骨折手术患者的影响。方法:选取2022年1月—2024年9月于肇庆市高要区人民医院行手术治疗的80例老年股骨粗隆间骨折患者,根据随机数字表法分为对照组和研究组,各40例。对照组行腰硬联合麻醉,研究组在对照组基础上复合右美托咪定麻醉。比较两组血流动力学指标、认知功能、不良反应发生情况。结果:麻醉后10 min、术毕时、术后1 h,对照组心率(HR)、平均动脉压(MAP)较麻醉前5min升高(P<0.05);研究组麻醉前5 min、麻醉后10 min、术毕时、术后1 h的HR、MAP比较,差异无统计学意义(P>0.05);麻醉后10min、术毕时、术后1h,研究组HR和MAP较对照组低(P<0.05)。术后1、3d,对照组简易精神状态量表(MMSE)得分较术前低(P<0.05);研究组术前、术后1d、术后3d的MMSE得分比较,差异无统计学意义(P>0.05);术后1、3d,研究组MMSE得分高于对照组(P<0.001)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:右美托咪定复合腰硬联合麻醉应用于老年股骨粗隆间骨折手术,有利于患者的血流动力学指标稳定,降低术后认知功能障碍发生率,安全性良好。Objective:To explore the effect of dexmedetomidine combined with lumbar epidural anesthesia on elderly patients with intertrochanteric fracture.Methods:A total of eighty elderly patients with intertrochanteric femoral fracture who underwent surgical treatment in Zhaoqing Gaoyao District People's Hospital from January 2022 to September 2024 were selected and divided into control group and study group according to random number table method,with forty cases in each group.The control group received combined epidural anesthesia,and the study group received combined dexmedetomidine anesthesia on the basis of the control group.Hemodynamic indexes,cognitive function and adverse reactions were compared between the two groups.Results:The heart rate(HR)and mean arterial pressure(MAP)of the control group were increased 10 min after anesthesia,at the end of surgery and 1 h after surgery compared with 5 min before anesthesia(P<0.05).There was no significant difference in HR and MAP in the study group 5 min before anesthesia,10 min after anesthesia,at the end of surgery and 1 h after surgery(P>0.05).HR and MAP in the study group were lower than those in the control group 10 min after anesthesia,at the end of surgery and 1 h after surgery(P<0.05).On the 1st and 3rd day after surgery,the score of Mini-mental State Scale(MMSE)in the control group was lower than that before operation(P<0.05).There was no significant difference in MMSE scores before surgery,1 day after surgery and 3 days after surgery(P>0.05).The MMSE score of the study group was higher than that of the control group on the 1st and 3rd day after surgery(P<0.001).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The application of dexmedetomidine combined with lumbar epidural anesthesia in the operation of elderly intertrochanteric fracture of femur is beneficial to the stability of hemodynamic indexes,the incidence of postoperative cognitive dysfunction,and the safety is good.

关 键 词：股骨粗隆骨折 右美托咪定 腰硬联合麻醉 老年 

分 类 号：R614[医药卫生—麻醉学]