瑞芬太尼联合右美托咪定对股骨远端骨折内固定术高龄患者术后谵妄和认知功能的影响  

Effects of remifentanil combined with dexmedetomidine on postoperative delirium and cognitive function in elderly patients undergoing internal fixation of distal femoral fracture

作　　者：李晓峰 Li Xiao-feng(Department of Anesthesiology,Kaifeng Hospital of Traditional Chinese Medicine,Kaifeng 475000,Henan,China)

机构地区：[1]开封市中医院麻醉科,河南开封475000

出　　处：《四川生理科学杂志》2025年第2期389-391,共3页

摘　　要：目的:探讨瑞芬太尼联合右美托咪定对股骨远端骨折内固定术高龄患者术后谵妄和认知功能的影响。方法:选取2022年12月至2023年12月期间本院收治的80例股骨远端骨折内固定术高龄患者作为研究对象。随机将患者分为对照组和研究组,各40例。两组均接受全身麻醉下股骨远端骨折内固定术。对照组采用丙泊酚和瑞芬太尼进行麻醉维持。研究组在对照组基础上联合右美托咪定进行麻醉维持。分析比较两组的血流动力学指标[心率(Heart rate,HR)、平均动脉压(Mean arterial pressure,MAP)]、术后谵妄(Postoperative delirium,POD)发生率、POD持续时间以及术后认知功能[采用简易智能精神状态检查量表(Mini-mental state examination,MMSE)]。结果:拔管前后,研究组的HR和MAP水平均明显低于对照组(P<0.05)。研究组POD发生率和POD发生率持续时间均明显低于对照组(P<0.05)。研究组的MMSE评分明显高于对照组(P<0.05)。结论:瑞芬太尼联合右美托咪定麻醉方案应用在股骨远端骨折内固定术高龄患者中,能够改善术后血流动力学稳定性,降低术后谵妄的发生率和持续时间,改善术后认知功能。Objective:To investigate the effects of remifentanil combined with dexmedetomidine on postoperative delirium and cognitive function in elderly patients with internal fixation of distal femoral fracture.Methods:The study included 80 senior patients treated at our institution between December 2022 and December 2023 for distal femoral fractures.The patients were randomly divided into control group and study group,with 40 cases in each group.Both groups received internal fixation of distal femoral fracture under general anesthesia.The control group was treated with propofol and remifentanil.The study group was maintained under anesthesia with dexmedetomidine on the basis of the control group.The hemodynamic parameters(Heart rate,HR;Mean arterial pressure,MAP)the incidence of postoperative delirium(POD),POD duration and postoperative cognitive function(Mini-mental state examination,MMSE)of the two groups were analyzed and compared.Results:Before and after extubation,the levels of HR and MAP in the study group were significantly lower than those in the control group(P<0.05).The incidence and duration of POD in the study group were significantly lower than those in the control group(P<0.05).The MMSE score of the study group was significantly higher than that of the control group(P<0.05).Conclusion:Remifentanil combined with dexmedetomidine can improve postoperative hemodynamic stability,reduce the incidence and duration of postoperative delirium,and improve postoperative cognitive function in elderly patients undergoing internal fixation of distal femoral fracture.

关 键 词：瑞芬太尼 右美托咪定 股骨远端骨折内固定术 术后谵妄 认知功能 

分 类 号：R614[医药卫生—麻醉学]