期刊文献+

盐酸戊乙奎醚对老年患者术后精神功能的影响 被引量:2

Effects of Penehyclidine Application before Operation on Postoperative Mental Function in the Elder
下载PDF
导出
摘要 目的观察不同剂量盐酸戊乙奎醚(长托宁)对老年人术后精神功能的影响。方法采用随机双盲对照实验。选择择期全麻下行腹腔镜胆囊切除手术老年患者120例。随机分为三组(每组40例),于入室麻醉前10 min,Ⅰ组(对照组)静注生理盐水1.0 ml;Ⅱ组静注长托宁0.5 mg;Ⅲ组静注长托宁1.0 mg。于术前1 d及术后72 h以简易智力状态量表(MMSE)行认知功能测定;气管导管拔除后观察病人1周精神功能状况,以ICU精神错乱评估法(CAM-ICU)行术后谵妄评估。结果三组气管导管拔除时间差异无统计学意义(P>0.05),术后72 hⅢ组MMSE评分为22.0±2.2,低于Ⅰ组和Ⅱ组(23.2±2.1,23.3±2.3,P<0.05),而Ⅱ组与对照组之间差异无统计学意义(P>0.05)。Ⅲ组术后精神障碍(谵妄)发生率35.0%,高于对照组(12.5%)和Ⅱ组(15.0%)(P<0.05)。结论长托宁增加到一定剂量,对老年患者术后精神功能有明显影响,增加术后谵妄的发生。 Objective To investigate the effects of different dose of penehyclidine application before operation on postoperative mental function in the elder.Methods 120 cases of old patients scheduled for laparoscope cholecystectomy operation under generalanesthesia,were randomly allocated into 3 groups(40 each): group one(control group) was premedicated with sodium choride injection 1ml intravenous infusion 10 min before anesthesia,group two was premedicated with penehyclidine 0.5mg,and group three received penehyclidine 1mg as premedication by the same way.The mini-mental state examination(MMSE) was performed for congnitive test l day before and 72 h after the operation.The postoperative mental state changes or delirium was evaluated with confusion assessment method for ICU(CAM-ICU) performed within one week after extubation.Results There were no significant differences involving the time of tube withdrawing(P〉0.05).The score of MMSE in group three was 22.0±2.2,lower than those in group one and group two(23.2±2.1,23.3±2.3,P〈0.05) at 72h after operation,whereas no significant differences between control group and group two(〉0.05).The incidence of postoperative mental state changes(delirium) group three was 35.0%,higher than those in control(12.5%)and two group(15.0%)(P〈0.05).Conclusion Application of different dose of penehyclidine adding to the degree before operation,provides significantly the danger of postoperative mental disfunction or postoperative delirium in the elder.
机构地区 解放军第
出处 《临床军医杂志》 CAS 2009年第6期1016-1018,共3页 Clinical Journal of Medical Officers
关键词 戊乙奎醚 术后 认知 智力测验 penehyclidine postoperative cognition intelligence tests
  • 相关文献

参考文献7

  • 1夏莉,李廷坤,董铁立.老年患者麻醉前应用长托宁和阿托品效果比较[J].郑州大学学报(医学版),2006,41(1):177-177. 被引量:4
  • 2朱彪,薛张纲.老年病人术后精神障碍的临床思维[J].中国临床医学,2004,11(4):672-674. 被引量:13
  • 3王思真,王志萍.术后精神功能障碍[M]//庄心良,曾目明,陈泊銮.现代麻醉学.第3版.北京:人民卫生出版社,2003:2233-2250.
  • 4Ely EW, Inoute SK, Bernard GR, et al. Delirium in mechanically ventilated patients: validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU) [ J]. JAMA, 2001,286(21 ) :2703 -2710.
  • 5Rasmussen IS, Moiler Jr. Central nervous system dysfunction after anesthesia in the geriatric patient[ J]. Anesthesiol Clin North Amer,2000,18 (1) :59 -70.
  • 6Ancelin ML, De Roquefeuil G, Ritchie K,et al. Anesthesia and post-operative cognitive dysfunction in the elderly: a review of clinical and epidemiologica] observations [ J ]. Rev Epidemiol Sante Publique ,2000,48 (5) :459 - 472.
  • 7王志萍.术后精神障碍影响因素的研究进展[J].国外医学(麻醉学与复苏分册),2003,24(1):10-13. 被引量:68

二级参考文献25

  • 1黄祥,柴小青.麻醉前应用长托宁与东莨菪碱对心率与血压的影响[J].安徽卫生职业技术学院学报,2004,3(3):16-18. 被引量:26
  • 2陈孝治.长托宁[J].中南药学,2003,1(3):188-189. 被引量:69
  • 3陈涌鸣,朱慧琛,王祥瑞.盐酸戊乙奎醚和阿托品对老年患者心率变异性及心率影响的比较[J].中华麻醉学杂志,2005,25(1):59-60. 被引量:47
  • 4顾振伦 卞春甫 张银绨.医学药理学[M].北京:科学出版社,1998.51-53.
  • 5Abildstrom H, Rasmussen LS, Rentowl P, et al. Cognitive dysfunction 1-2 years after non-cardiac surgery in the elderly. ISPOCD group. International Study of Post-Operative Cognitive Dysfunction. Acta Anaesthesiol Scand, 2000,44 ( 10 ): 1246-1251.
  • 6Dijkstra JB, Jolles J. Postoperative cognitive dysfunction versus complaints: a discrepancy in long-term findings. Neuropsychol Rev, 2002,12(1): 1-14.
  • 7Winawer N. Postoperative delirium. Med Clin North Am, 2001,85(5): 1229-1239.
  • 8Ancelin ML, De Roquefeuil G, Ritchie K, et al. Anesthesia and postoperative cognitive dysfunction in the elderly: a review of clinical and epidemiological observations. Rev Epidemiol Sante Publique,2000,48(5) :459-472.
  • 9Johnson T, Monk T, Rasmussen LS, et al. Postoperative cognitive dysfunction in middle-aged patients. Anesthesiology, 2002, 96(6):1351-1357.
  • 10Rasmussen LS, Moller JT. Central nervous system dysfunction after anesthesia in the geriatric patient. Anesthesiol Clin North America, 2000,18(1) :59-70.

共引文献80

同被引文献38

  • 1郭艺.护理干预对ICU谵妄患者影响的研究[J].当代护士(下旬刊),2010,17(4):3-4. 被引量:14
  • 2朱广球,尤匡掌.麻醉前应用戊乙奎醚对老年人术后早期精神功能的影响[J].中国新药与临床杂志,2007,26(4):280-283. 被引量:7
  • 3Lee JK, Park YS. Delirium after spinal surgery in Korean population [ J ]. Spine ( Phila Pa 1976 ) , 2010,35 ( 18 ) : 1729- 1732.
  • 4Leung JM. Postoperative delirium: are there modifiable risk factors? [ J]. Eur J Anaesthesiol ,2010 ,27 (5) :403-405.
  • 5Rudolph JL, Marcantonio ER. Review articles: postoperative delirium : acute change with long-term implications J ]. Anesth Analg,2011,112(5) :1202-1211.
  • 6Edelstein DM, Aharonoff GB, Karp A, et al. Effect of postoperative delirium on outcome after hip fracture [ J ]. Clin Orthop Relat Res,2004 (422) : 195-200.
  • 7Wiesel O, Klausner J, Softer D, eta]. Post-operative delirium of the elderly patient-an iceberg.'? [ J ]. Harefuah, 2011,150 ( 3 ) : 260-263, 303.
  • 8Aldemir M, Ozen S, Kara IH, et al. Predisposing factors for delirium in the surgical intensive care unit [ J ]. Crit Care, 2001,5 (5) :265-270.
  • 9谭刚.老年非心脏手术患者术后谵妄的临床研究[D].北京:中国协和医科大学,2007.
  • 10Quellette RG, Quellette SM. Understanding postoperative cognitive[J]. OR Nurse,2010,4(4) :40-46.

引证文献2

二级引证文献20

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部