右美托咪定在降低老年腰椎手术患者术后认知功能障碍发生率中的应用价值

The Value of Dexmedetomidine in Reducing the Incidence of Postoperative Cognitive Dysfunction in Elderly Patients Undergoing Lumbar Spine Surgery

目的选取右美托咪定应用在老年腰椎手术中对患者术后认知功能障碍的影响做研究。方法选取2018年1月至2019年1月红河州滇南中心医院(个旧市人民医院)就诊的老年腰椎手术患者90例,依据抽签法随机分组,分为A、B、参照三组,各30例。手术结束前40 min分别给予A组0.5 ug/kg的右美托咪定,B组0.8 ug/kg的右美托咪定持续泵入10 min,并在手术结束前30 min停止泵注,参照组予以相同剂量的生理盐水。对三组患者镇痛药物使用剂量、窦性心动过缓等指标以及认知功能障碍发生率等进行比较。结果相比于A组和B组,参照组的镇痛药物使用剂量均较高,组间差异有统计学意义(P<0.05);相比于参照组,A组和B组患者的窦性心动过缓发生率,组间数据对比差异性有统计学意义(P<0.05);B组患者的认知功能障碍发生率低于A组和参照组,组间数据对比,差异有统计学意义(P<0.05)。结论对老年腰椎手术患者予以右美托咪定麻醉镇痛,可将镇痛药物的使用剂量降低,有利于患者术后认知功能改善,临床上具有较高的应用价值。

Objective To select the application of dexmedetomidine in elderly lumbar spine surgery to study the effect of postoperative cognitive dysfunction in patients.Methods A total of 90 elderly patients undergoing lumbar spine surgery in South Yunnan Central Hospital of Honghe Prefecture(People's Hospital of Gejiu City)from January 2018 to January 2019 were selected and randomly divided into three groups with 30 cases in each group.Patients in group A and group B were given dexmedetomidine at 0.5 ug/kg in group A 40 min before the end of surgery,and dexmedetomidine at 0.8 ug/kg in group B was pumped continuously for 10 min,and stopped 30 min before the end of surgery pump injection,the reference group was given the same dose of normal saline.The dosage of analgesic drugs,sinus bradycardia and the incidence of cognitive dysfunction in the three groups were compared.Results Compared with group A and group B,the dosage of analgesic drugs in the reference group was higher,and the difference between the groups was significant(P<0.05);compared with the reference group,the patients in group A and group B had sinus bradycardia Incidence rate,the difference in data comparison between groups was significant(P<0.05);the incidence of cognitive dysfunction in group B was lower than that in group A and the reference group,and there were significant differences in data between groups(P<0.05).Conclusion Dexmedetomidine analgesia for elderly patients undergoing lumbar spine surgery can reduce the dosage of analgesic drugs,which is beneficial to the improvement of postoperative cognitive function of patients and has high clinical application value.