右美托咪定对胸腔镜老年肺癌根治术后患者谵妄发生率的影响

Effect of dexmedetomidine on delirium after thoracoscopic radical resection of lung cancer in elderly patients

目的探讨右美托咪定对胸腔镜老年肺癌根治术后患者谵妄发生率的影响。方法选取2016年1月至2019年1月咸阳市第一人民医院的胸腔镜肺癌根治术后老年患者56例,随机分为右美托咪啶组和0.9%氯化钠溶液组,各28例。比较2组患者谵妄发生率、重度谵妄发生率、谵妄持续时间、不良反应发生率、睡眠质量评分和术后疼痛视觉模拟评分。结果右美托咪啶组和0.9%氯化钠溶液组患者在谵妄发生率(7.1%和28.6%)、重度谵妄发生率(0.0%和14.3%)、谵妄持续时间[(1.5±0.7)d和(2.8±0.4)d]、不良反应发生率(0.0%和21.4%)、睡眠质量评分[(3.2±1.3)分和(6.4±2.7)分]及术后疼痛数字评分[(3.3±2.2)分和(5.4±1.8)分]方面,应用右美托咪啶组结果优于对照组,差异有统计学意义(均P<0.05)。结论老年患者全身麻醉下行胸腔镜肺癌根治术,麻醉时应用右美托咪啶可降低谵妄和重度谵妄的发生率,缩短谵妄的持续时间。

Objective To investigate the effect of dexmedetomidine on delirium after thoracoscopic radical resection of lung cancer in elderly patients.Methods Fifty-six elderly patients undergoing thoracoscopic radical lung cancer surgery in Xianyang First People's Hospital from January 2016 to January 2019 were randomly divided into dexmedetomidine group and saline group,each group with 28 cases.The incidence of delirium,incidence of severe delirium,duration of delirium,inci⁃dence of adverse reactions,sleep quality score and visual analogue score of postoperative pain were compared between the 2 groups.Results In terms of the incidence of delirium(7.1%vs.28.6%),the incidence of severe delirium(0.0%vs.14.3%),the duration of delirium[(1.5±0.7)d vs.(2.8±0.4)d],the incidence of adverse reactions(0.0%vs.21.4%),the sleep quality score[(3.2±1.3)vs.(6.4±2.7)]and the number of pain scores after operation[(3.3±2.2)vs.(5.4±1.8)],the dexmedetomidine group were better than the control group,and the difference was statistically significant(all P<0.05).Conclusion In el⁃derly patients after lung resection,preoperative and intraoperative application of dexmedetomidine can decrease the inci⁃dence of delirium,decrease the intensity of delirium,and shorten the duration of delirium.