摘要
目的探究右美托咪定对术前贫血的髋关节置换老年患者术后认知功能的影响。方法选取术前贫血的单侧髋关节置换的老年患者90例,随机分为对照组和观察组(各45例),对照组患者进行常规麻醉,观察组患者在常规麻醉基础上加用右美托咪定,对术前24 h(T1)、术后24 h(T2)及术后72 h(T3)两组患者的认知功能、麻醉药物使用量以及麻醉苏醒期情况等进行比较。结果两组患者在T2、T3时间点的简易智能精神状态检查量表(MMSE)评分及连线测验(TMT)评分比较,差异均有统计学意义(P<0.05),观察组患者的术后认知功能障碍(POCD)发生率显著低于对照组,差异有统计学意义(P<0.05);两组患者在麻醉期间的丙泊酚及瑞芬太尼使用量差异均有统计学意义(P<0.05);两组患者的疼痛视觉模拟评分(VAS)及苏醒期躁动人数的差异均有统计学意义(P<0.05)。结论右美托咪定能够显著降低术前贫血的髋关节置换老年患者术后认知功能的受损程度,降低POCD的发生率,减少麻醉药物的使用量,改善患者苏醒期疼痛程度,减少患者苏醒期躁动的发生率。
Objective To investigate the effect of dexmedetomidine on the cognitive function of older patients with preoperative anemia after hip replacement.Methods 90 preoperative anemic patients with unilateral hip replacement in Shuyang Hospital Affiliated to Xuzhou Medical University were randomly divided into the control group(45 cases)and the observation group(45 cases).The patients in the control group were routinely anesthetized,and the patients in the observation group were routinely anesthetized and treated with dextromethoridine.The cognitive function,the dosage of anesthetic and the patient's manifestation during anesthesia recovery were compared between the two groups at 1 day before operation(T1),24 hours after operation(T2)and 72 hours after operation(T3).Results There were significant differences in mini-mental state examination(MMSE)score and tairl making text(TMT)score at T2 and T3 time points(P<0.05).The incidence of postoperative cognitive dysfunction(POCD)in the observation group was significantly lower than that in the control group(P<0.05).There were significant differences in the dosages of propofol and remifentanil between the two groups during the anesthesia(P<0.05).There were significant differences in visual analogue scale(VAS)score and the number of patients with emergence agitation in the recovery period between the two groups(P<0.05).Conclusion Dexmedetomidine might effectively reduce the degree of postoperative cognitive impairment,reduce the incidence of postoperative cognitive dysfunction,reduce the use of anesthetic,relieve pain and reduce the incidence of emergence agitation in older patients with preoperative anemia after hip replacement.
作者
徐小艳
刘秀
汪涛
Xu Xiaoyan;Liu Xiu;Wang Tao(Anesthesiology College,Xuzhou Medical University,Xu Zhou 221004;Shuyang Hospital Affiliated to Xuzhou Medical University,Shu Yang 223600)
出处
《国际老年医学杂志》
2021年第3期152-154,172,共4页
International Journal of Geriatrics
基金
江苏省卫计委指导性课题(z2017009)。
关键词
右美托咪定
贫血
髋关节置换
术后认知功能障碍
Dexmedetomidine
Anemia
Hip replacement
Postoperative cognitive dysfunction
