CAJ | 학술논문

目的：探讨不同剂量右美托咪定对老年腹腔镜下结直肠癌手术术后认知功能的影响。方法选取2010年10月至2014年5月该院收治的88例择期全麻下拟行腹腔镜下结直肠癌手术老年患者，随机分为4组，每组22例；D1组、D2组、D3组分别给予右美托咪定0．5、0．8、1．0μg? kg－1? h－1，对照组给予等容量0．9％氯化钠注射液，采用 MMSE 量表对老年患者手术后的认知功能进行评定。结果对照组及 D1组治疗后MMSE评分明显低于治疗前（P＜0．05）；D2组和D3组术后的MMSE评分与术前无明显差异（P＞0．05）。 D2组、D3组患者高血压以及窦性心律过缓的发生率均明显高于对照组（P＜0．05）。术后，D1组、D2组、D3组和对照组患者认知功能障碍的发生率分别为31．82％（7／22）、4．55％（1／22）、0％（0／22）、36．36％（8／22），D2组、D3组患者认知功能障碍的发生率显著低于对照组和 D1组（P＜0．05），D1组与对照组比较差异无统计学意义（P＞0．05）。结论右美托咪啶应用于老年腹腔镜下结直肠癌手术镇痛，在改善术后认知功能方面具有明显的优势，但在使用过程中，建议采取低于1．0μg／kg剂量给药，并密切监测生命体征。
목적：탐토불동제량우미탁미정대노년복강경하결직장암수술술후인지공능적영향。방법선취2010년10월지2014년5월해원수치적88례택기전마하의행복강경하결직장암수술노년환자，수궤분위4조，매조22례；D1조、D2조、D3조분별급여우미탁미정0．5、0．8、1．0μg? kg－1? h－1，대조조급여등용량0．9％록화납주사액，채용 MMSE 량표대노년환자수술후적인지공능진행평정。결과대조조급 D1조치료후MMSE평분명현저우치료전（P＜0．05）；D2조화D3조술후적MMSE평분여술전무명현차이（P＞0．05）。 D2조、D3조환자고혈압이급두성심률과완적발생솔균명현고우대조조（P＜0．05）。술후，D1조、D2조、D3조화대조조환자인지공능장애적발생솔분별위31．82％（7／22）、4．55％（1／22）、0％（0／22）、36．36％（8／22），D2조、D3조환자인지공능장애적발생솔현저저우대조조화 D1조（P＜0．05），D1조여대조조비교차이무통계학의의（P＞0．05）。결론우미탁미정응용우노년복강경하결직장암수술진통，재개선술후인지공능방면구유명현적우세，단재사용과정중，건의채취저우1．0μg／kg제량급약，병밀절감측생명체정。
Objective To investigate the effects of different dose of dexmedetomidine ( Dex ) on postoperative cognitive function ( POCD) in elderly patients with laparoscopic colorectal cancer surgery.Methods 88 elderly patients with laparoscopic colorectal cancer surgery under general anesthesia were randomly divided into four groups,22 cases in each group,D1,D2 and D3 group were given 0.5,0.8, 1.0 μg? kg-1? h-1 right holder microphones respectively, the control group was given 0.9% sodium chloride injection,the occurrence of postoperative cognitive dysfunction of the four groups was compared by MMSE scale after surgery.Results MMSE score after treatment in control and D1 groups were significantly lower than those before treatment (P<0.05).The postoperative MMSE scores of D2 and D3 groups had no obvious differences compared with preoperative MMSE scores(P>0.05).The incidences of hypertension and sinus rhythm slow of D2 and D3 groups were significantly higher than those of control group(P<0.05).The incidences of cognitive dysfunction in D2 and D3 group were significant lower than those of control and D1 groups(P<0.05),but there was no statistically significant difference between D1 and con-trol groups(P>0.05).Conclusions Dex has obvious advantages in improving postoperative cognitive function,but it is recommended to take less than 1.0 μg/kg dose,and closely monitor vital signs.