盐酸右美托咪定在扁桃体切除术中的麻醉效果及对术后认知功能的影响分析

Analysis of the anesthetic effect of dexmedetomidine hydrochloride in tonsillectomy and its effect on postoperative cognitive function

目的分析盐酸右美托咪定在扁桃体切除术中的麻醉效果及对术后认知功能的影响。方法选择2015年1月至2017年1月本院耳鼻咽喉科接诊的扁桃体疾病患者100例，随机数字表法分为观察组和对照组，每组50例，对照组采用常规方式麻醉，观察组采用盐酸右美托咪定麻醉，比较两组麻醉效果，分析盐酸右美托咪定对患者术后认知功能的影响。结果观察组丙泊酚用量为（73．51±8．45）mg，显著低于对照组的（111．75±9．67）mg，观察组躁动评分为（1．05±0．37），显著低于对照组的（2．67±0．76），差异有统计学意义（P〈0．05）。术后1d，观察组MMSE评分为（25．64±2．37），显著高于对照组的（22．02±1．02）观察组拔管恢复时间、呼吸恢复时间、意识恢复时间分别为（16．57±3．51）min、（10．34±3．48）min、（12．24±3．43）min，显著短于对照组，差异有统计学意义（P〈0．05）。结论扁桃体切除术中应用盐酸美托咪啶麻醉，有助于提高麻醉效果，改善患者术后认知功能，减少麻醉苏醒后躁动，确保手术安全。

Objective To study the anesthetic effect of dexmedetomidine hydrochloride in tonsillectomy and its effect on postoperative cognitive function. Methods 100 cases of tonsil diseases from E.N.T. department of our hospital from January 2015 to January 2017 were selected and were divided into observation group and control group according to the random number table, 50 cases in each group. The control group received conventional anesthetic methods, and the observation group received dexmedetomidine hydrochloride anesthesia. The anesthetic effect of the two groups were compared and the effect of dexmedetomidine hydrochloride on postoperative cognitive function of the patients was analyzed. Results The dosage ofpropofol in the observation group was less than that in the control group [（73.51±8.45）mg vs.（111.75±9.67）mg], the score of agitation in the observation group was lower than that in the control group [（1.05±0.37） vs.（2.67±0.76）] （P〈0.05）. Postoperative 1 d MMSE score of the observation group was higher than that of the control group [（25.64±2.37） vs.（22.02±1.02）] （P〈0.05）. The recovery time of extubation, breathing, and consciousness of the observation group were （16.57±3.51）min, （10.34±3.48）min, （12.24±3.43）min, shorter than those of the control group （P〈0.05）. Conclusion The application of dexmedetomidine hydrochloride anesthesia in tonsillectomy helps to impreprove the anesthetic effect, improve postoperative cognitive function in patients, reduce restlessness after anesthesia, ensure the safety of operation.