右美托咪定预防老年患者髋部手术后谵妄的效果

Effect of Dexmedetomidine on Preventing Delirium After Hip Surgery in Elderly Patients

目的研究右美托咪定预防老年患者髋部手术术后谵妄的临床疗效。方法选取2018年4月~2019年4月我院诊治的114例老年髋部手术患者为研究对象,采用随机数字表法分为对照组和观察组,各57例。观察组术前给予右美托咪定,对照组术前给予等量生理盐水,比较两组术后谵妄发生率、发生时间、谵妄持续时间、手术开始和术毕生命体征(收缩压、舒张压、心率、血氧饱和度)变化及不良反应发生情况。结果观察组术后谵妄发生率(12.28%)低于对照组(26.31%),差异有统计学意义(P<0.05);观察组术后谵妄发生时间长于对照组,谵妄持续时间短于对照组,差异有统计学意义(P<0.05);手术开始时,两组收缩压、舒张压、心率、血氧饱和度比较,差异无统计学意义(P>0.05);术毕时观察组收缩压、舒张压、心率低于对照组,差异有统计学意义(P<0.05),两组血氧饱和度比较,差异无统计学意义(P>0.05);观察组不良反应发生率与对照组比较,差异无统计学意义(P>0.05)。结论老年患者髋部手术时应用右美托咪定可降低谵妄的发生,缩短谵妄持续时间,有助于维持围麻醉期患者血液动力学基本稳定,安全性良好。

Objective To study the clinical efficacy of dexmedetomidine in preventing delirium after hip surgery in elderly patients.Methods A total of 114 elderly hip surgery patients diagnosed and treated in our hospital from April 2018 to April 2019 were selected as the research objects,and they were divided into the control group and the observation group by random number table,with 57 cases in each group.The observation group was given dexmedetomidine before the operation,and the control group was given the same amount of normal saline before the operation.The incidence,time,duration of delirium,start of operation and vital signs(systolic blood pressure,diastolic blood pressure,diastolic blood pressure)were compared between the two groups.Pressure,heart rate,blood oxygen saturation)changes and adverse reactions.Results The incidence of postoperative delirium in the observation group(12.28%)was lower than that in the control group(26.31%),the difference was statistically significant(P<0.05);the postoperative delirium occurred in the observation group was longer than the control group,and the duration of delirium was shorter than the control group,the difference was statistically significant(P<0.05);at the beginning of the operation,there was no significant difference in systolic blood pressure,diastolic blood pressure,heart rate,blood oxygen saturation between the two groups(P>0.05);At the end of the operation,the observation group's systolic blood pressure,diastolic blood pressure,and heart rate were lower than those of the control group,the difference was statistically significant(P<0.05).There was no statistically significant difference in blood oxygen saturation between the two groups(P>0.05);There was no significant difference in the incidence of adverse reactions between the observation group and the control group(P>0.05).Conclusion The use of dexmedetomidine during hip surgery in elderly patients could reduce the occurrence of delirium,shorten the duration of delirium,and help maintain the basic hemodynamic stability of patients during peri-anaesthesia with good safety.