右美托咪定对老年患者全麻术后认知功能影响.pdfVIP

摘要 高(PO．05)，在T2、T3、T4、T5时无明显变化(P0．05) (3)S100B蛋白组内比较：Dl组术后l小时(TB)血清S100B蛋白含量与 泵注右美托咪定前(TA)有明显升高(P0．05)；D2组术后1小时(TB)血清 S100B蛋白含量与泵注右美托咪定前(TA)无明显变化(PO．05)；M组术后1 小时(TB)血清S100B蛋白含量与泵注右美托咪定前(TA)有明显升高(P0．05) 组问比较：三组病人术前泵注右美托咪定前血清S100B蛋白含量无明显差异 (P0．05)。术后1小时Dl组和M组之间血清S100B蛋白含量无明显差异 (PO．05)，D2组明显低于Dl和M组(P0．05)。 (4)三组患者的POCD发生情况： 术后第l天，三组共发生POCD 23例，发生率为25．6％。其中Dl组8例， 组内发生率为26．7％：D2组1例，组内发生率为3．3％：M组14例，组内发生 率为46．7％。Dl组POCD发生率与M组之间无明显差异(PO．05)；D2组POCD 发生率明显低于D1组和M组(P0．05)。 术后第3天，三组共发生POCD 13例，发生率为14．4％。其中Dl组5例， 组内发生率为14．4％；D2组0例；M组8例，发生率为26．7％。DI组POCD发 生率与M组比，无明显差异(P0．05)；D2组FOCD发生率明显低于Dl组和M 组(P0．05)： 术后第5天三组共发生POCD 4例，发生率为4．4％。其中Dl组2例，组内 发生率6．7％：D2组0例：M组2例，组内发生率6．7％。D1组POCD发生率与 M组比较无明显差异(P0．05)；D2组POCD发生率明显低于D1组和M组 (P0．05)： 结论：与注射咪达唑仑0．05mg．kg‘1相比，诱导前静脉泵注右美托咪定 0．6p,g·kgJ能减轻老年手术患者脑损害，降低老年手术患者POCD的发生率；诱 导前静脉注射0．399·kgo右美托咪啶则效果不明显。 关键词：老年患者；认知功能障碍；右美托咪定；全身麻醉；S100B蛋白 Abstract ABSTRACT Objective：The objective is to investigate the influence on cognitive function produced by dexmedetomidine given to elderly patients by the means of assessing the value of Mini—Mental State Examination(MMSE)and dynamic observing the level of the S100B protein in venous blood． Methods：There were 90 inpatients suffered ASA I-II noncardiac surgery of general anesthesia were randomly divided into three groups．After the patients had got in the operation room and had the standard monitors，30 cases were intravenous injected of midazolam 0．05mg．kg叫(group M)，30 patients were pumped dexmedetomidine 0．399．kgq(group D1)for 15 min and another 30 patients were pumped dexmedetomidin0．6lag．k91(group D2、for 1 5 min．We recorded the Diastole blood pressure(DBP)，Systolic blood pressure(SBP)and Heart rate(HR)at 5 min after entrance(To)，1 0 min after the infusion of dexmedetomidine or midazolam(T1)， endotracheal intubation(T2)，1 h after the infusion of dexmedetomidine(T3)，the end of surgery(T4)，removal of tracheal catheter(Ts)，1 0 rain after extubation(T6)．The blood sample were taken before given medicine and one hour af