右美托咪定对患者髋关节置换术后早期认知功能的影响观察

To observe the effects of hip replacement early postoperative cognitive dysfunction by dexmedetomidine

目的 观察右美托咪定对患者髋关节置换术后早期认知功能的影响.方法 选取浙江省义乌市中心医院骨科2015年1月-2016年2月收治的行髋关节置换术患者共73例,按随机、双盲分为观察组36例和对照组37例.观察组患者麻醉前给予静脉滴注右美托咪定处理,对照组患者同时给予滴注等量生理盐水,2组患者均接受全麻方案.观察比较2组患者治疗前后的简易精神状态量表（MMSE）、不同时段中枢神经特异蛋白（S100β）水平、第3天神经精神测验功能恶化情况.结果 ①观察组患者治疗后第3天和第7天MMSE评分均高于对照组,组间相比差异具有统计学意义（P〈0.05）;观察组患者治疗后第3天和第7天S100β水平均低于对照组,组间相比差异具有统计学意义（P〈0.05）;②观察组患者术后第3天POCD发生率为13.89%,明显低于对照组48.72%（P〈0.05）;③观察组患者治疗后总有效率为92.86%,明显高于对照组35.14%（P〈0.05）.结论 右美托咪定对患者髋关节置换术后早期认知功能有较为显著的改善作用,可以降低POCD的发生率.

Objective To investigate the effects of hip replacement early postoperative cognitive dysfunction by dexmedetomidine.Methods73 were admitted hip arthroplasty patients from January 2015 to February 2016,randomized, double-blind divided into observation group of 36 cases and a control group of 37 cases.Observe patients before anesthesia intravenous infusion dexmedetomidine given treatment, while the control group were given normal saline infusion, patients received general anesthesia program.Mini-Mental State Examination was observed before and after comparison of two groups of patients （MMSE）, central nervous system specific proteins at different times （S100β） level, the third day of neuropsychological test function deterioration.ResultsThe patients in the observation group third and seventh days MMSE scores were higher, compared to the difference between the two groups was significant （P〈0.05）;and the third day after the seventh day S100β level observation group patients They were lower than the control group, compared to the difference between the two groups was significant （P〈0.05）;the third day POCD postoperative patients in the observation group was 13.89%, significantly lower than the control group, 48.72% （P〈0.05）;③ observed after patients total effective rate was 92.86%, significantly higher than 35.14% （P〈0.05）.ConclusionDexmedetomidine given to patients after hip replacement early cognitive function have a more significant improvement, it can reduce the incidence of POCD.