右美托咪定与咪达唑仑复合腰硬联合麻醉对经尿道前列腺电切术患者术中应激反应和术后认知功能的影响

Effect of dexmedetomidine and midazolam combined with CSEA on TURP patients' stress response and postoperative cognitive function

目的分析右美托咪定与咪达唑仑复合腰硬联合麻醉对经尿道前列腺电切术(TURP)患者术中应激反应和术后认知功能的影响。方法选择在该院接受住院治疗的TURP患者作为研究对象,随机分为咪达唑仑复合腰硬联合麻醉的对照组、右美托咪定复合腰硬联合麻醉的观察组,比较两组患者的血清S100β水平、应激水平及术后认知功能等差异。结果观察组患者接受右美托咪定复合腰硬联合麻醉后各个时间点的血清S100β水平均明显低于对照组(P<0.05)。观察组患者的应激指标肾上腺素(E)、去甲肾上腺素(NE)、肾素(R)以及血管紧张素Ⅱ(ATⅡ)水平均明显低于对照组(P<0.05)。观察组患者术后各个时间点的认知功能评分均明显高于对照组(P<0.05)。结论右美托咪定复合腰硬联合麻醉可以更为有效的减轻围术期应激反应,减少对患者认知功能的抑制作用。

[ Objective ] To analyse effect of dexmedetomidine and midazolam combined with combined spinal epidnral anesthesia （CSEA） on transurethral resection of prostate （TURP） patients＇ stress response and postoperative cognitive function. [ Methods ] TURP patients in our hospital were enrolled as research objects and randomly divid- ed into control group received midazolam combined with CSEA, observation group received dexmedetomidine com- bined with CSEA. Then two group patients＇ serum level of S100β, stress level and postoperative cognitive function were compared. [Results] Serum S100β levels of observation group patients at each time after surgery were signifi- candy lower than those of control group patients （P 〈 0.05）. Stress indexes such as epinephrine （E）, noradrenaline （NE）, renin （R）, angiotensin Ⅱ （ATⅡ） levels of observation group patients were significantly lower than those of con- trol group patients （P 〈 0.05）. Observation group patients＇ cognitive function scores at each time after surgery were significantly higher than those of control group patients （P 〈 0.05）. [ Conclusions ] Dexmedetomidine combined with CSEA can more effectively reduce perioperative stress reaction, reduce inhibitory effeetion on postoperative cognitive function of patients.