右美托咪定对患者全髋置换术后早期认知功能的影响分析.docVIP

右美托咪定对患者全髋置换术后早期认知功能的影响分析 　　【摘 要】目的：评价麻醉过程中联合盐酸右美托咪定对患者全髋关节置换术后早期认知功能影响。方法：选取2011年10月至2012年11月在郑州大学第五附属医院骨科住院择期行全髋关节置换术患者142例，随机分为右美托咪定联合组和对照组，右美托咪定联合组在麻醉诱导后联合使用盐酸右美托咪定。对两组患者手术麻醉效果进行比较，并采用简易智力状态检测量表对患者认知情况进行评价。结果：两组患者在手术过程中均未出现呼吸暂停、心动过缓、肌阵挛等不良反应；右美托咪定联合组患者麻醉时间长于对照组（P0.05），而芬太尼量和丙泊酚量均少于对照组，差异均具有统计学意义（P0.05）；右美托咪定联合组患者自主呼吸恢复时间、睁眼时间和拔管时间均短于对照组，差异均具有统计学意义（P0.05）；右美托咪定联合组患者MMSE评分高于对照组（P0.05），认知障碍发生率为4.23%，远低于对照组的14.08%（P0.05）。结论：全髋关节置换术麻醉过程中联合盐酸右美托咪定可以提高麻醉效果，减少全麻药物用量，促进患者术后唤醒，减少认知功能障碍的发生。 　　【关键词】盐酸右美托咪定；全髋关节置换术；早期认知；影响 　　【中图分类号】R97 【文献标识码】A 【文章编号】1004-7484（2014）04-1915-02 　　Analysis on the Effect of Early Cognitive Dysfunction of Patients after Hip Arthroplasty by Dexmedetomidine Hydrochloride 　　【Abstract】Objective： To investigate the effect of patients with hip arthroplasty by dexmedetomidine hydrochloride on early cognitive dysfunction. Methods： 142 cases of patients in orthopedic inpatient elective total hip arthroplasty were selected from October 2011 to November 2012 at the Fifth Affiliated Hospital of Zhengzhou University. All the cases were randomly divided into dexmedetomidine combined group and control group. Cases in dexmedetomidine combined group were given combination dexmedetomidine hydrochloride after induction of anesthesia. Anesthesia effects of two groups were compared. The cognitions of patients were evaluated by using mini-mental state detection scale. Results：Apnea， bradycardia， myoclonus and other adverse reactions during surgery were not appeared in the two groups. The anesthesia time of dexmedetomidine combined group was longer than the control group （P0.05）. The amounts of fentanyl and propofol were less than the control group， the differences were all statistically significant （P0.05）. the recovery time of spontaneous breathing， eye opening time and extubation time of patients in dexmedetomidine combined group were shorter than the control group， the differences were all statistically significant （P0.05）. The MMSE score of patients in dexme