不同剂量右美托咪定复合七氟醚对老年全麻患者术后认知功能影响.docVIP

不同剂量右美托咪定复合七氟醚对老年全麻患者术后认知功能的影响 　　【摘要】 目的：分析不同剂量右美托咪定复合七氟醚对老年全麻患者术后认知功能的影响。方法：将本院收治的75例老年手术患者随机分为对照组和不同剂量右美托咪定组（M0、M1、M2、M3组）五组，右美托咪定组患者给予右美托咪定负荷剂量0.8 μg/kg，输注时间10～15 min，以0、0.2、0.4、0.6 μg/（kg?h）的速率持续至术毕，对照组给予等容量的生理盐水。并观察分析五组患者麻醉后对患者的影响。结果：清醒后1 h和术后6 d五组患者MMES评分比较差异无统计学意义（P0.05）；而清醒后3 h、术后1、3 d M2和M3组MMES评分下降程度明显优于其他3组，差异有统计学意义（P0.05）；M3组自主呼吸恢复时间、拔管时间以及定向力恢复时间和呼之睁眼时间均明显高于对照组、M0、M1、M2组，差异有统计学意义（P0.05）；M2和M3组POCD发生率明显低于其他3组，差异有统计学意义（P0.05）。结论：临床对老年全麻手术患者实施0.4 μg/（kg?h）右美托咪定复合七氟醚不仅能够降低术后早期认知功能障碍的发生率，同时安全性和可行性好，是右美托咪定复合七氟醚最佳给药方案，值得临床推广使用。 　　【关键词】 老年患者； 右美托咪定； 七氟醚； 术后认知功能 　　【Abstract】 Objective：To analyze the effect of different dose dexmedetomidine combined with sevoflurane on cognitive function of elderly patients after general anaesthesia.Method：75 elderly patients with operation were selected in our hospital and randomly divided into the control group and the different dose dexmedetomidine M0，M1，M2，M3 group，the patients of the dexmedetomidine groups were treated with dexmedetomidine loading dose of 0.8 g/kg，infusion time 10～15 min，at a rate of 0，0.2，0.4，0.6 μg/（kg?h）until the end of operation，the control group was given equal volume of physiological saline.The effects on patients of five groups after anesthesia were analyzed and observed.Result：There was no significantly difference in statistics between the awake after 1 hours and 6 days after surgery in patients with MMES score（P0.05）；while awake after 3 hours，after 1 days and 3 days operation in M2 and M3 groups，MMES score decreased significantly better than the other three groups，the difference was statistically significant （P0.05）；M3 group spontaneous breathing recovery time，extubation time and recovery time orientation of the eyes and respiratory time were significantly higher than M0，M1，M2 group，the differences were statistically significant（P0.05）；M2 and M3 group in POCD were obviously lower than the other three groups，the differences were statistically significant（P0.05）.Conclusion：In the clinic utilizing，