中国医药科学
中國醫藥科學
중국의약과학
CHINA MEDICINE AND PHARMACY
2014年
15期
68-70,83
,共4页
髋关节置换术%右美托咪定%全身麻醉
髖關節置換術%右美託咪定%全身痳醉
관관절치환술%우미탁미정%전신마취
Hip replacement surgery%Dexmedetomidine%General anesthesia
目的：探讨右美托咪定对全身麻醉下髋关节置换术术后老年患者认知功能的影响，为全身麻醉下髋关节置换术辅助用药的选择提供依据。方法选择于我院择期行髋关节置换手术的老年患者72例，分为观察组和对照组，每组36例。观察组在术前给予右美托咪定辅助全身麻醉患者的镇静，然后两组皆给予全身麻醉下髋关节置换术和相应常规处理，并通过简易精神状态量表（mini-mental state examination，MMSE）评估患者认知功能的改变以及认知功能障碍的发生率。结果观察组与对照组患者在体液量、手术时间、麻醉时间等方面无显著统计学差异（P＞0.05）。在术后S100蛋白含量方面差异有统计学意义（P＜0.05）。在术后第1天、第7天的MMSE评分存在统计学差异。术后第3天，对照组认识功能障碍的发生率为27.78%（10/36），观察组认识功能障碍的发生率为19.45%（7/36），两组间存在统计学差异（P＜0.05）。术后第9天，两组患者认知能力均有部分恢复，对照组发生率为16.67%（6/36），观察组发生率为8.3%（3/36），两组间存在统计学差异（P＜0.05）。结论研究发现右美托咪定具有明显的镇静作用，能够帮助改善老年患者全身麻醉下髋关节置换术后的认知功能障碍。
目的：探討右美託咪定對全身痳醉下髖關節置換術術後老年患者認知功能的影響，為全身痳醉下髖關節置換術輔助用藥的選擇提供依據。方法選擇于我院擇期行髖關節置換手術的老年患者72例，分為觀察組和對照組，每組36例。觀察組在術前給予右美託咪定輔助全身痳醉患者的鎮靜，然後兩組皆給予全身痳醉下髖關節置換術和相應常規處理，併通過簡易精神狀態量錶（mini-mental state examination，MMSE）評估患者認知功能的改變以及認知功能障礙的髮生率。結果觀察組與對照組患者在體液量、手術時間、痳醉時間等方麵無顯著統計學差異（P＞0.05）。在術後S100蛋白含量方麵差異有統計學意義（P＜0.05）。在術後第1天、第7天的MMSE評分存在統計學差異。術後第3天，對照組認識功能障礙的髮生率為27.78%（10/36），觀察組認識功能障礙的髮生率為19.45%（7/36），兩組間存在統計學差異（P＜0.05）。術後第9天，兩組患者認知能力均有部分恢複，對照組髮生率為16.67%（6/36），觀察組髮生率為8.3%（3/36），兩組間存在統計學差異（P＜0.05）。結論研究髮現右美託咪定具有明顯的鎮靜作用，能夠幫助改善老年患者全身痳醉下髖關節置換術後的認知功能障礙。
목적：탐토우미탁미정대전신마취하관관절치환술술후노년환자인지공능적영향，위전신마취하관관절치환술보조용약적선택제공의거。방법선택우아원택기행관관절치환수술적노년환자72례，분위관찰조화대조조，매조36례。관찰조재술전급여우미탁미정보조전신마취환자적진정，연후량조개급여전신마취하관관절치환술화상응상규처리，병통과간역정신상태량표（mini-mental state examination，MMSE）평고환자인지공능적개변이급인지공능장애적발생솔。결과관찰조여대조조환자재체액량、수술시간、마취시간등방면무현저통계학차이（P＞0.05）。재술후S100단백함량방면차이유통계학의의（P＜0.05）。재술후제1천、제7천적MMSE평분존재통계학차이。술후제3천，대조조인식공능장애적발생솔위27.78%（10/36），관찰조인식공능장애적발생솔위19.45%（7/36），량조간존재통계학차이（P＜0.05）。술후제9천，량조환자인지능력균유부분회복，대조조발생솔위16.67%（6/36），관찰조발생솔위8.3%（3/36），량조간존재통계학차이（P＜0.05）。결론연구발현우미탁미정구유명현적진정작용，능구방조개선노년환자전신마취하관관절치환술후적인지공능장애。
Objective To study the influence of dexmedetomidine on the elderly patients' postoperative cognitive function after the hip replacement surgery under general anesthesia in order to provide reference for the selection of adjuvant drugs in the hip replacement surgery under general anesthesia. Methods Seventy-two elderly patients who received selective hip replacement surgery in our hospital were selected and divided into the observation group and the control group, with 36 patients in each group. The observation group was given dexmedetomidine before the surgery for the purpose of adjuvant sedation of the patients receiving general anesthesia and then both groups were given the hip replacement surgery under general anesthesia and relevant conventional treatment.The mini-mental state examination(MMSE) was used to evaluate the patients'cognitive function changes and the incidences of cognitive dysfunction. Results The observation group and the control group were not significantly different in the body fluid volume,surgical time and anesthetic time(P>0.05),but were significantly different in the postoperative S100 protein content(P<0.05) and were significantly different in the postoperative 1-day and 7-day MMSE scores. On day 3 after the surgery,the incidence of cognitive dysfunction of the control group was 27.78%(10/36) and that of the observation group was 19.45%(7/36),with statistical significance between the two groups(P<0.05).On day 9 after the surgery,the cognitive function of both groups recovered partially;The incidence of the control group was 16.67%(6/36) and that of the observation group was 8.3%(3/36),with statistical significance between the two groups (P<0.05). Conclusion The study finds that dexmedetomidine has obvious sedation effect and can help improve the elderly patients'postoperative cognitive dysfunction after the hip replacement surgery under general anesthesia.
