不同剂量右美托咪定复合七氟醚对老年患者全麻术后认知功能影响.docVIP

不同剂量右美托咪定复合七氟醚对老年患者全麻术后认知功能的影响 　　[摘要] 目的 探讨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 方便选取2013年8月―2015年8月该院收治的老年手术患者60例，将其随机分为对照组、低剂量组和高剂量组，每组20例；低剂量组和高剂量组分别给予右美托咪定0.4 μg/kg、0.8 μg/kg静脉输注，给予对照组适量的生理盐水，观察并记录患者手术前后的BIS值及MMSE评分，并对3组患者的POCD发生率进行比较。结果 与手术前相比，三组患者的BIS值、MMSE评分情况均发生明显的改变，且低剂量组POCD发生率15.0%和高剂量组POCD发生率10.0%均低于对照组的40.0%，差异有统计学意义（P0.05）。结论 临床上使用右美托咪定复合七氟醚有利于老年患者全麻术后认知功能的恢复。 　　[关键词] 右美托咪定；七氟醚；老年全麻患者；术后认知功能 　　[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2016）08（b）-0141-03 　　[Abstract] Objective To investigate the influence of the different doses of dexmedetomidine combined with sevoflurane on cognitive function in postoperative patients with general anesthesia in the elderly.Methods Convenient selection a total of 60 in our hospital of August 2013 to August 2015 the elderly surgical patients were selected， and randomly divided to control group， low dose group and high dose group， 20 cases in each group； low dose group and high dose group were given dexmedetomidine 0.4 μg/kg， 0.8 μg/kg intravenous infusion， given to the control group， the amount of physiological saline， and MMSE score were observed and recorded before and after the operation of the BIS value and of patients in the three groups of POCD occurred rate were compared. Results Compared with before surgery， three groups of patients with BIS values， the MMSE score occurred obvious change and low dose group the incidence of POCD was 15.0% and high dose group of POCD occurred rate was 10.0% were lower than 40% in the control group， the difference is statistically significant （P 0.05）. Conclusion The clinical use of dexmedetomidine combined with sevoflurane have cognitive function recovery for elderly patients after general anesthesia. 　　[Key words] Dexmedetomidine；Sevoflurane；Elderly patients with general anesthesia；Postoperative cognitive function 　　随着近年来中国老龄化问题越来越严重，而老年人免疫力较低，导致发病率逐年增加，需要进行手术治疗并施以全身麻醉，而全身麻醉会对患者的术后认知功能造成不良影响，术后认知功能障碍（POCD）是老年患者术后出现的较为显著的问题，因此改善手术后麻醉引起的不良反应问题受到了社会广泛关注[1-3]。该次研究主要对不同剂量右美托咪定复合七氟醚对该院20