不同剂量右美托咪定对老年腹腔镜下结直肠癌术后认知功能的影响  

Effect of different dose of dexmedetomidine onpostoperative cognitive function in elderly patients with laparoscopic colorectal cancer surgery

作　　者：柏平[1] 陶国才 吕治全[1] 

机构地区：[1]重庆医科大学附属永川医院麻醉科,重庆402160 [2]重庆西南医院麻醉科

出　　处：《中国老年学杂志》2015年第3期669-671,共3页Chinese Journal of Gerontology

基　　金：国家自然科学基金资助项目(81171034)

摘　　要：目的探讨不同剂量右美托咪定对老年腹腔镜下结直肠癌手术术后认知功能的影响。方法选取2010年10月至2014年5月该院收治的88例择期全麻下拟行腹腔镜下结直肠癌手术老年患者,随机分为4组,每组22例;D1组、D2组、D3组分别给予右美托咪定0.5、0.8、1.0μg·kg-1·h-1,对照组给予等容量0.9%氯化钠注射液,采用MMSE量表对老年患者手术后的认知功能进行评定。结果对照组及D1组治疗后MMSE评分明显低于治疗前(P<0.05);D2组和D3组术后的MMSE评分与术前无明显差异(P>0.05)。D2组、D3组患者高血压以及窦性心律过缓的发生率均明显高于对照组(P<0.05)。术后,D1组、D2组、D3组和对照组患者认知功能障碍的发生率分别为31.82%(7/22)、4.55%(1/22)、0%(0/22)、36.36%(8/22),D2组、D3组患者认知功能障碍的发生率显著低于对照组和D1组(P<0.05),D1组与对照组比较差异无统计学意义(P>0.05)。结论右美托咪啶应用于老年腹腔镜下结直肠癌手术镇痛,在改善术后认知功能方面具有明显的优势,但在使用过程中,建议采取低于1.0μg/kg剂量给药,并密切监测生命体征。Objective To investigate the effects of different dose of dexmedetomidine( Dex) on postoperative cognitive function( POCD) in elderly patients with laparoscopic colorectal cancer surgery. Methods 88 elderly patients with laparoscopic colorectal cancer surgery under general anesthesia were randomly divided into four groups,22 cases in each group,D1,D2 and D3 group were given 0. 5,0. 8,1. 0 μg·kg- 1·h- 1right holder microphones respectively,the control group was given 0. 9% sodium chloride injection,the occurrence of postoperative cognitive dysfunction of the four groups was compared by MMSE scale after surgery. Results MMSE score after treatment in control and D1 groups were significantly lower than those before treatment( P < 0. 05). The postoperative MMSE scores of D2 and D3 groups had no obvious differences compared with preoperative MMSE scores( P > 0. 05). The incidences of hypertension and sinus rhythm slow of D2 and D3 groups were significantly higher than those of control group( P < 0. 05). The incidences of cognitive dysfunction in D2 and D3 group were significant lower than those of control and D1 groups( P < 0. 05),but there was no statistically significant difference between D1 and control groups( P > 0. 05). Conclusions Dex has obvious advantages in improving postoperative cognitive function,but it is recommended to take less than 1. 0 μg / kg dose,and closely monitor vital signs.

关 键 词：右美托咪啶 术后认知功能 腹腔镜 

分 类 号：R614[医药卫生—麻醉学]