右美托咪定对老年全髋关节置换术患者的影响

Effect of Dexmedetomidine on Elderly Patients Undergoing Total Hip Replacement

目的观察右美托咪定(Dex)对老年全髋关节置换术(THR)患者应激反应及术后早期睡眠质量的影响。方法选取2018年7月—2019年7月在本院进行全款关节置换术的患者90例,结合患者意愿分为对照组和观察组,各45例,观察组切皮前给予0.5μg/kg Dex泵注,对照组给予生理盐水。比较两组患者用药前、用药50 min后及手术结束时血清中肾上腺素(E)、去甲肾上腺素(NE)含量,采用匹兹堡睡眠质量指数量表(PSQI)评价患者术后三日的睡眠质量并比较。结果两组患者用药前E、NE含量差异无统计学意义(P>0.05);用药50min及术毕观察组E、NE含量低于对照组(P<0.05);术后三日观察组的PSQI评分均低于对照组,差异有统计学意义(P<0.05)。结论Dex可降低老年患者THR术中应激反应,提高术后睡眠质量,促进患者创口愈合,有临床使用价值。

Objective To observe the effect of dexmedetomidine(Dex)on stress response and early sleep quality in elderly patients undergoing total hip replacement(THR).Methods Ninety patients who underwent total arthroplasty in our hospital from July 2018 to July 2019 were divided into control group and observation group according to patients’wishes,45 cases in each group,The observation group was given 0.5μg/kg Dex pump before skin incision,while the control group was given normal saline.The serum levels of epinephrine(E)and norepinephrine(NE)were compared between the two groups before,50 minutes after and at the end of operation,pittsburgh sleep quality index(PSQI)was used to evaluate and compare the sleep quality of patients three days after operation.Results There was no significant difference in the content of E and NE between the two groups before treatment(P>0.05);the content of E and NE in the observation group was lower than that in the control group at 50 min and after operation(P<0.05);the PSQI score of the observation group was lower than that of the control group three days after the operation,and the difference was statistically significant(P<0.05).Conclusion Dex can reduce the stress reaction during THR in elderly patients,improve the quality of sleep after THR,and promote wound healing.It has clinical value.