不同剂量盐酸右美托咪定对骨科手术患者术后恢复及血清CRP的影响

Effect of dexmedetomidine on postoperative recovery and serum CRP in patients undergoing orthopaedic surgery

目的:探讨不同剂量盐酸右美托咪定(DEX)对骨科手术患者术后恢复及血清CRP的影响。方法:选取2018年1月—2019年9月在我院骨科接受骨科手术治疗的患者68例作为研究对象,按照麻醉维持DEX剂量的不同分为高剂量组(n=23)、低剂量组(n=23)以及生理盐水组(n=22)。三组麻醉诱导方法一致,高剂量组给予DEX0.8(kg·h)持续静脉泵入,低剂量组给予DEX0.4(kg·h)持续静脉泵入,生理盐水组给予同等剂量0.9%氯化钠持续静脉泵入。比较三组认知功能、苏醒时间、拔管时间、血清CRP水平以及并发症发生率。结果:术后1 d以及术后3 d,低剂量组MMES评分均高于高剂量组和生理盐水组,差异有统计学意义(P<0.05)。术后1 d以及术后3 d低剂量组血清CRP低于高剂量组和生理盐水组,差异有统计学意义(P<0.05)。高剂量组并发症发生率为60.9%(14/23),高于低剂量组和生理盐水组,差异有统计意义(P<0.05)。结论:对骨科手术患者采用0.4μg/(kg·h)盐酸右美托咪定持续静脉泵入有利于提高患者术后认知功能,缩短苏醒时间和拔管时间,降低血清CRP水平和并发症的发生,促进患者康复。

Objective:To investigate the effect of dexmedetomidine(DEX)in different doses on postoperative recovery and serum CRP in orthopedic patients.Methods:From January 2018 to September 2019,68 patients who received orthopedic surgery in our orthopedic department were divided into high dose group(n=23),low dose group(n=23)and normal saline group(n=22)according to the different doses of anesthesia maintaining DEX.The anesthesia induction methods of the three groups were the same,the high dose group was given DEX 0.8μg(kg·h),the low dose group was given DEX 0.4μg/(kg·h),and the normal saline group was given the same dose of 0.9%sodium chloride.The cognitive function,recovery time,extubation time,serum CRP level and the incidence of complications were compared among the three groups.Results:The scores of MMES in the low dose group were higher than those in the high dose group and the normal saline group on the first day and the third day after operation,the difference was statistically significant(P<0.05).The serum CRP of the low dose group was lower than that of the high dose group and the normal saline group on the first day and the third day after operation,the difference was statistically significant(P<0.05).The incidence of complications in high dose group was 60.9%,which was higher than that in low dose group and normal saline group(P<0.05).Conclusion:Continuous intravenous infusion of 0.4μg/(kg·h)dexmedetomidine hydrochloride can improve the cognitive function,shorten the recovery time and extubation time,reduce the level of serum CRP and complications,and promote the recovery of patients.