丁螺环酮与氟哌啶醇治疗老年患者全麻术后精神障碍的对比分析

Effects comparison of buspirone and haloperidol in elderly patients with postoperative psychonosema after general anesthesia

目的评价丁螺环酮联合氯硝西泮治疗老年患者全麻术后精神障碍(POP)的有效性。方法随机选取武警陕西总队医院2010年1月至2017年1月全院76例行全身麻醉术发生POP的老年患者,按照列表法随机分为试验组(38例)与对照组(38例)。试验组患者口服丁螺环酮,对照组患者肌内注射氟哌啶醇,两组患者均于必要时给予氯硝西泮肌内注射。比较两组患者的Riker镇静-激越量表(SAS)评分,用药前、后生命体征(包括血压、心率、氧饱和度、呼吸频率等)。结果所有患者随访2周、1、3月,未出现复发且无需持续服用抗精神失常药物。治疗后,两组患者的收缩压、舒张压、心率呼吸频率均较治疗前有改善,且试验组患者上述各项指标优于对照组(P<0.05)。两组患者治疗后的SAS评分均降低(P<0.05),但两组患者的SAS评分组间无显著差异(P>0.05)。结论丁螺环酮是治疗老年急性POP安全、有效的药物,值得临床推广应用。

Objective To evaluate the effect of buspirone and haloperidol in elderly patients with postoperative psychonosema(POP)after general anesthesia.Methods From January 2010 to June 2017,76 cases of elderly patients with POP in Armed Police Corps Hospital of Shaanxi were randomly selected and divided into experimental group(38 cases)and control group(38 cases)according to the list method.The experimental group was treated with oral buspirone,while the control group was given haloperidol intramuscular injection,both groups were given clonazepam intramuscular when necessary.The riker sedation-exacerbation(SAS)scores,vital signs(including blood pressure,heart rate,oxygen saturation,respiration rate,etc.)before and after treatment were compared between the two groups.Results All patients were followed up for 2 weeks,1 and 2 months,there was no recurrence and no need to continue taking antipsychotics.After treatment,the systolic blood pressure,diastolic blood pressure,heart rate and respiratory rate in both groups improved compared with those before treatment,and those indexes above in the experimental group were better than the control group(P<0.05).The SAS scores of both groups decreased after treatment(P<0.05),but there was no significant difference in the SAS score between the two groups(P>0.05).Conclusion Buspirone is safe and effective in elderly patients with acute POP,and it is worthy of clinical application.