摘要
目的探讨维持剂量右美托咪定对妇科老年全麻手术患者术后认知功能的影响。方法选取2014年4月至2016年4月我院收治的92例妇科老年全麻手术患者,随机分为A组和B组(每组46例),2组患者均予以相同麻醉诱导及维持药物,手术开始时,A组患者予静脉输注右美托咪定0.8ug/kg,并以0.5ug/(kg·h)的剂量维持至术毕,B组患者予静脉等速输入等量生理盐水,比较2组患者不同时刻其神经烯醇化酶(NSE)、白介素-6(IL-6)、C-反应蛋白(CRP)和血清高迁移率族蛋白1(HMGB1)的水平以及不同时间的认知功能情况及认知功能障碍(POCD)发生率,并观察患者术后不良反应的发生。结果 (1)2组患者在术后不同时间点IL-6和CRP的水平较术前均明显升高,且B组患者升高水平明显高于A组(P<0.05);(2)2组患者术后不同时刻其NSE和HMGB1水平较术前均升高,且B组升高程度明显(P<0.05);(3)2组患者在术后不同时刻其简易智能量表评分(MMSE评分)较术前均降低,且B组较A组降低明显(P<0.05)。结论右美托咪定可改善行妇科手术的全麻老年患者的术后认知功能,并可有效降低术后POCD的发生率,且无明显不良反应,可作为全麻手术患者的一种麻醉辅助药物。
Objective To investigate the influence of maintenance dose DEX on postoperative cognitive function of senile patient with general anesthesia after gynecological operation. Methods 92 senile patients with general anesthesia in our hospital from April 2014 to April 2016 were selected and divided into group A and group B, 46 cases in each group. Patients were all given same anesthesia induction and maintenance dose. Group A was given DEX intravenous infusion 0.8ug/kg and maintenance dose 0.5ug/（ kg·h ） . Group B was given intravenous infusion intravenous infusion. The NSE, IL-6, CRP, HMGBI, cognitive function and POCD occurrence rate at different times and the adverse reactions between two groups were evaluated and compared. Results （ 1 ） The levels of IL-6 and CRP in two groups at different times were higher than those at before, and the level of group B was significantly higher than that of group A （P 〈 0.05 ） ; （ 2 ） The levels of NSE and HMGB 1 in two groups at postoperative different were higher than those at before, and B group increased significantly （P 〈 0.05 ） ; （ 3 ） the levels of MESS in two groups at different times was declined, it declined more obviously in group B than that in group A （P 〈 0.05 ） . Conclusion DEX can improve cognitive function of senile patients with general anesthesia after gynecological operation and can lower POCD occurrence rate. No severe adverse reactions occurred after surgery. DXE can be seen as a auxiliary anesthetic drug.
出处
《国际精神病学杂志》
2017年第3期506-508,515,共4页
Journal Of International Psychiatry
关键词
维持剂量
右美托咪定
妇科手术
全麻老年患者
术后认知功能
Maintenance dose
DEX
GynecoLogical operation
Senile patients with general anesthesia
Postoperative cognitive function
作者简介
肖红霞（1968．08-），女，山东德州人，本科，副主任医师，研究方向：临床麻醉的基础研究。[通讯作者]肖红霞（Email：wwwaaa2233@163．com）。
