右美托咪定对老年腹部手术患者术后镇静效果及认知功能的影响

Effect of dexmedetomidine on sedation and cognitive function in elderly patients after abdominal operation

目的：探讨右美托咪定对老年腹部手术患者术后镇静效果及认知功能的影响。方法选择2013年1月-2014年1月在我科接受腹部手术患者共100例，分为观察组（泵注右美托咪定﹚和对照组（泵注生理盐水﹚，每组各50例，比较两组患者用药前及用药后10 min、用药后30 min的Ramsay评分的变化，两组患者术前1 d、术后1 d、术后3 d、术后7 d MMSE评分的变化，两组患者术前（T0﹚、术后5 min（T1﹚、拔管前15 min（T2﹚、拔管时30 min （T3﹚的收缩压（SBP﹚、舒张压（DBP﹚、心率（HR﹚和血氧饱和度（SpO2﹚的变化情况。结果观察组患者用药后10 min、用药后30 min Ramsay评分分别高于对照组，差异有显著性（P﹤0.05﹚。对照组患者术后1 d 、术后3 d的MMSE评分分别低于观察组，差异有显著性（P﹤0.05﹚。两组患者T2、T3时点的SBP水平分别较T0明显升高，但对照组显著高于观察组，差异有显著性（P﹤0.05﹚。对照组患者的DBP水平较T0显著升高，且T2、T3时点对照组患者的DBP水平显著高于观察组，而观察组患者的DBP水平明显T0-T2变化不显著（P﹥0.05﹚。对照组患者T1-T3时点的HR分别高于观察组，差异有显著性（P﹤0.05﹚。结论右美托咪定应用于老年腹部手术患者术后镇静效果好，患者的认知功能术后恢复快，并维持血流动力学稳定。

Objective To investigate the effect of dexmedetomidine on sedation and cognitive function in elderly pa-tients after abdominal operation. Methods From January 2013 to January 2014 in our department,100 cases of abdominal operation were randomly divided into observation group （infusion of dexmedetomidine﹚ and control group （infusion of saline﹚,50 cases in each group, compared two groups of patients before treatment and 10 min after administration, 30 min after administration of Ramsay score changes,changes in the two groups before operation 1 days, 1 days after operation,postoperative 3 days,7 days after operation,MMSE score, the two groups before operation （T0﹚, 5 min after operation（T1﹚,before extubation 15 min T2﹚,extubation 30 min（T3﹚systolic blood pressure （SBP﹚,diastolic blood pres-sure （DBP﹚,heart rate（HR﹚ and oxygen saturation（SpO2﹚changes. Results Patients with 10 min after administration, 30 min Ramsay after administration scores were higher than those in the control group,there was significant difference （P〈0.05﹚. The MMSE score of the patients in control group after operation 1 d, postoperative were lower than that of the observation group,there was significant difference （P〈0.05﹚. 2 groups of patients with T2 in T3,SBP levels were significantly higher than T0,but the control group was significantly higher than those in the observation group,there was significant difference（P〈0.05﹚. Patients in the control group DBP level was T0 increased significantly,and the level of DBP in patients with T2 group,T3 was significantly higher than that in the control group,and the observation of DBP level significantly changes in T0-T2 group were not significant （P〉0.05﹚. Patients in control group and T1-T3 in HR were higher than that of the observation group,there was significant difference（P〈0.05﹚. Conclusion Dexmedetomidine for sedation in elderly patients after abdominal operation,the cognitive function of patients recovered quickly,and can maintain the stability of hemodynamics.