右美托咪定对老年颌面颈部多间隙感染患者全麻术后认知功能的影响  

The post-operation effects of cognitive function with using dexmedetomidine in maxillofacial and neck multi space infection in elderly

作　　者：肖剑锐 赵三军 于新馨 陈书军 胡燕 陈宇轩 XIAO Jian-rui;ZHAO San-jun;YU Xin-xin;CHEN Shu-jun;HU Yan;CHEN Yu-xuan(Department of Stomatology,the 82nd Group Army Hospital,BaoDing 071000,China)

机构地区：[1]陆军第八十二集团军医院口腔科,保定071000 [2]陆军第八十二集团军医院麻醉科,保定071000

出　　处：《中华老年口腔医学杂志》2025年第1期12-15,22,共5页Chinese Journal of Geriatric Dentistry

基　　金：中部战区2023年度医学自主科研课题(2023LC05)。

摘　　要：目的探讨老年颌面颈部多间隙感染患者全麻时使用右美托咪定对术后认知功能的影响。方法选取2020年6月至2023年6月于陆军第八十二集团军医院行全麻插管下颌面颈部间隙感染脓肿切开引流并置入负压吸引装置治疗的老年患者48例,随机分为2组,试验组26例术中加用盐酸右美托咪定,对照组22例予以生理盐水对照。对比2组术后是否发生谵妄、苏醒时的质量、疼痛评分和认知功能评价。结果试验组术后谵妄发生率低于对照组(0.0%vs 9.1%,P<0.05)。2组睁眼时间、自主呼吸恢复时间比较,差异无统计学意义(P>0.05);试验组苏醒状态更加稳定、躁动减少、血流动力学更加稳定,心率、血压变化率低于对照组(P<0.05)。试验组术后8 h、12 h疼痛评分低于对照组(P<0.05);2组术后24 h、48 h疼痛评分比较,差异无统计学意义(P>0.05)。2组术后简易精神状态量表评分、蒙特利尔认知评估量表评分均低于术前(P<0.05);试验组术后简易精神状态量表评分、蒙特利尔认知评估量表评分均高于对照组(P<0.05)。结论老年颌面颈部多间隙感染患者在全麻下行感染脓肿切开引流术,术中使用右美托咪定,可减少术后谵妄发生、提高苏醒质量、减轻疼痛、促进认知功能恢复。Objective To discuss the effects of cognitive function in elderly patients by using dexmedetomidine(DMED)in maxillofacial and neck space infection under general anesthesia.Methods Selecting 48 elderly patients with maxillofacial and neck multi space infection at the 82nd Group Army Hospital from June 2020 to June 2023,they were treated with incision and drainage of the infected abscesses and inserted into negative pressure suction devices under intubation general anesthesia.They were randomly divided into 2 groups,and 26 in the experimental group was administrated with dexmedetomidine,while the 22 in control group was given placebo instead,and then comparing the incidence of postoperative delirium(POD),the revival quality,the pain grade and the cognitive function grade between the two groups.Results The incidence of POD were lower in the experimental group comparing with the control group(0.0%vs 9.1%,P<0.05).The revival eyelid open time and the spontaneous breath recovery time were no statistical significance between the two groups(P>0.05).The experimental group has a more stable awakening state,reduced restlessness,and more stable hemodynamics,and the changing rate of heart rate and blood pressure were lower in the experimental group(P<0.05).The pain grade at 8h and 12h of revival were lower in the experimental group(P<0.05),while that at 24 h and 48 h were no statistical significance between the two groups(P>0.05).The postoperative MMSE scores and MoCA scores were both lower than that at the preoperative in the 2 groups(P<0.05),and the 2 scores in the experimental group were both higher than that in the control group(P<0.05).Conclusion Using dexmedetomidine during operation with elderly maxillofacial and neck multi space infection patients under general anesthesia could reduce POD,increase the quality of revival,reduce pain,and promote the recovering of cognitive function.

关 键 词：右美托咪定 颌面颈部 多间隙感染 全麻 谵妄 

分 类 号：R782[医药卫生—口腔医学]