CAJ | 학술논문

目的：观察右美托咪定复合氯胺酮麻醉对老年烧伤患者术后认知功能的影响。方法选择年龄≥65岁的老年烧伤患者60例，随机分为氯胺酮组（ K组）和右美托咪定复合氯胺酮组（ DK组）各30例，采用简易精神状态量表（ MMSE）评分方法，观察两组分别应用氯胺酮麻醉和右美托咪定复合氯胺酮麻醉术前1 d、术后1d、3d及7d对老年烧伤患者认知功能的影响，并进行比较分析。结果与术前1d比较，两组患者术后1 d、3 d及7 d MMSE评分均下降（ P＜0.05），但DK组下降的幅度小于K组（ P＜0.05）。 K组与DK组术后认知功能障碍（ POCD）发生率分别为26.7％和23.3％，两组比较差异无统计学意义（ P＞0.05）。结论右美托咪定复合氯胺酮麻醉可改善氯胺酮引起的老年烧伤患者 POCD，但不能降低氯胺酮引起的POCD发生率。
목적：관찰우미탁미정복합록알동마취대노년소상환자술후인지공능적영향。방법선택년령≥65세적노년소상환자60례，수궤분위록알동조（ K조）화우미탁미정복합록알동조（ DK조）각30례，채용간역정신상태량표（ MMSE）평분방법，관찰량조분별응용록알동마취화우미탁미정복합록알동마취술전1 d、술후1d、3d급7d대노년소상환자인지공능적영향，병진행비교분석。결과여술전1d비교，량조환자술후1 d、3 d급7 d MMSE평분균하강（ P＜0.05），단DK조하강적폭도소우K조（ P＜0.05）。 K조여DK조술후인지공능장애（ POCD）발생솔분별위26.7％화23.3％，량조비교차이무통계학의의（ P＞0.05）。결론우미탁미정복합록알동마취가개선록알동인기적노년소상환자 POCD，단불능강저록알동인기적POCD발생솔。
Objective To study the effects of dexmedetomidine combined with ketamine on postoperative cognitive dysfunction in elderly patients with burns .Methods Sixty cases of the elderly patients with burns were ad-ministered anesthetic ketamine (group K, n=30) and the other cases were administered anesthetic dexmedetomidine combinedation with ketamine (group DK, n=30).The postoperative cognitive dysfunctions in the groups were ob-served respectively on the first , the third and the seventh day after operation .Results Scores of MMSE in the two groups were both decreased compared with pre-operation(P<0.05).On the third and seventh day the scores in the two groups were increased than those on the first day in some extent , but they were both significantly lower than those before operation ( P<0.05 ) .The score of group K was significantly decreased compared with group DK ( P<0.05 ) . The percentages of POCD in both group K and group DK had no significant difference ( P>0.05 ) .Conclusion Dexmedetomidine combined with ketamine in anesthesia improves postoperative cognitive dysfunction in elderly pa -tients with burns compared with using ketamine alone .It has no effect on the occurrence of POCD .