摘要
目的：探讨右美托咪定在老年患者髋关节置换术中的应用及术后认知功能的影响.方法：选择2013年2月～2016年12月入我院治疗的髋关节置换术老年患者120例作为研究对象,根据信封随机抽签原则分为观察组与对照组各60例,所有患者在硬膜外麻醉下行单侧髋关节置换手术,观察组采用右美托咪定辅助诱导麻醉,对照组采用丙泊酚诱导辅助麻醉,记录2组预后与术后认知功能情况.结果：观察组与对照组的苏醒时间分别为12.64±4.23分钟与20.44±7.21分钟,观察组明显少于对照组（t=5.202,P＜0.05）.观察组与对照组T1与T2时间点的MAP与HR对比无明显差异（P＞0.05）,观察组T3与T4时间点的MAP与HR明显低于对照组（P＜0.05）.与术前相比,观察组与对照组术后14天的认知功能障碍发生率分别为3.3％和13.3％,且观察组认知功能障碍发生率显著少于对照组（P＜0.05）.观察组术后14天的呼吸抑制、低血压、高血压、心动过缓等不良反应发生率为13.3％,对照组为45.0％,观察组低于对照组（P＜0.05）.结论：右美托咪定在老年患者髋关节置换术中的应用有利于诱导苏醒期间血流动力学稳定,在促进患者苏醒的基础上减少不良反应的发生,减少术后认知功能障碍的发生率.
Objective：To explore the effects of postoperative cognitive function and application of dexmedetomidine in elderly patients with hip replacement. Methods： From February 2013 to December 2016, 120 elderly patients for hip replacement in our hospital were se- lected as the research object, all the patients were equally divided into the observation group and control group with 60 patients in each group accorded to the envelope principles, all patients were given unilateral hip replacement surgery in epidural anesthesia, the observa- tion group was given the dexmedetomidine assisted anesthesia induction, the control group was given the propofol assisted anesthesia, re- corded the postoperative cognitive function and the prognosis in the two groups. Results： The recovery time of the observation group and the control group were 12.64 ± 4.23 rain and 20.44 ± 7.21 min, respectively, and the observation group was significantly less than the control group （ t = 5. 202, P 〈 0.05 ）. There were no significant difference in MAP and HR compared between the observation group and the control group at T1 and T2 points（P 〉0.05）, while the MAP and HR in the observation group at T3 and T4 points were significantly lower than those in the control group （ P 〈 0.05 ）. The postoperative 14d of incidence of cognitive dysfunction in the observation group and the control group were 3.3% and 13.3%, respectively, the incidence of cognitive dysfunction in the observation group was significantly less than that in the control group （P 〈 0.05）. The postoperative 14d of incidence of respiratory depression, hypotension, hypertension, bradycardia and other adverse reactions in the observation group was 13.3%, and that of the control group was 45.0%. The incidence of adverse reactions in the observation group was significantly lower than that in the control group （ P 〈 0.05 ）. Conclusion： The application of dexmedetomidine in elderly patients with hip arthreplasty in favor of hemodynamic stability during induction of anesthesia and recovery, it can reduce the incidence of adverse reactions in the foundation to promote patient recovery, and it can reduce the incidence of postopera- tive cognitive dysfunction.
出处
《中国伤残医学》
2017年第23期11-14,共4页
Chinese Journal of Trauma and Disability Medicine
