摘要
目的:研究右美托咪定(Dex)复合瑞芬太尼麻醉在老年腹部手术中的麻醉效果及对术后认知功能障碍(POCD)的影响。方法:选取我院2019年9月至2022年9月收治的老年腹部手术患者120例,以随机数字表法分为A组(n=60)与B组(n=60)。B组患者选用瑞芬太尼麻醉,A组患者则选用Dex复合瑞芬太尼麻醉。对比两组患者的血流动力学、认知功能情况、应激反应、苏醒质量指标。结果:A组患者插管时各项血流动力学指标水平均高于B组患者(P<0.05)。A组患者术后1、3、7 d简易智能状态检查量表(MMSE)评分均高于B组(P<0.05),且术后1 d的POCD发生率低于B组(P<0.05)。A组患者术后1 d丙二醛(MDA)水平低于B组,而超氧化物歧化酶(SOD)及总抗氧化能力(T-AOC)水平均高于B组患者(P<0.05)。A组患者自主呼吸恢复时间、睁眼时间、拔管时间、定向力恢复时间均早于B组患者(P<0.05)。结论:Dex复合瑞芬太尼麻醉应用于老年腹部手术的麻醉效果较佳,可降低患者POCD发生风险,减轻应激反应,提升苏醒质量。
Objective:To investigate the anesthetic effect of dexmedetomidine(Dex)combined with remifentanil in elderly patients undergoing abdominal surgery and its effect on postoperative cognitive dysfunction(POCD).Methods:A total of 120 elderly patients underwent abdominal operation in our hospital from September 2019 to September 2022 were selected and divided into the group A(n=60)and the group B(n=60)by random number table method.Remifentanil was used as anesthesia in the group B and Dex combined with remifentanil was used as anesthesia in the group A.The indexes of hemodynamics,cognitive function,stress response and recovery quality of the two groups of patiens were compared.Results:The hemodynamic indexes of patients in the group A were higher than those in the group B during in tubation(P<0.05).The scores of mini-mental state examination(MMSE)of patients in the group A were higher than those in the group B at 1,3 and 7 d after surgery(P<0.05),and the incidence of POCD in the group A was lower than that in the group B at 1 d after surgery(P<0.05).The level of malondialdehyde(MDA)of patients in the group A was lower than that in the group B at 1 d after surgery,while the levels of superoxide dismutase(SOD)and total antioxidant capacity(T-AOC)of patients in the group A were higher than those in the group B(P<0.05).The recovery time of spontaneous respiration,eye opening time,extubation time and orientation recovery time of patients in the group A were earlier than those in the group B(P<0.05).Conclusion:Dex combined with remifentanil has good anesthetic effect in elderly patients undergoing abdominal surgery,which can reduce the risk of POCD,reduce stress response and improve the quality of recovery.
作者
李旭辉
LI Xuhui(Jianxi Branch,Luoyang Hospital of Traditional Chinese Medicine,Henan Luoyang 471003,China)
出处
《中国医药导刊》
2024年第4期412-416,共5页
Chinese Journal of Medicinal Guide
关键词
腹部手术
右美托咪定
瑞芬太尼
麻醉效果
术后认知功能障碍
Abdominal surgery
Dexmedetomidine
Remifentanil
Anesthetic effect
Postoperative cognitive dysfunction
