右美托咪定对老年患者心脏手术后谵妄的影响

Effect of dexmedetomidine on postoperative delirium in elderly patients undergoing cardiac surgery

目的:分析右美托咪定对老年患者心脏手术后谵妄发生情况的影响。方法:将96例接受了全麻心脏手术的老年患者随机分为对照组和观察组各48例。术后,对照组给予氟哌啶醇和丙泊酚泵入治疗,观察组给予右美托咪定泵入治疗。比较两组谵妄发生比例和持续时间,达到镇静目标的比例和药物使用时间,ICU停留时长和总住院时长,以及不良反应发生情况。结果:观察组术后7 d内谵妄发生比例和持续时间均明显低于对照组;前期达到镇静目标的比例明显高于对照组;使用镇静药物治疗时间、不良反应发生情况少于对照组(均P<0.05)。结论:右美托咪定能有效减少老年患者心脏手术后谵妄的发生率、缩短其持续时间,减少镇静药物的使用时间,利于患者恢复,值得临床进一步试验。

Objective:To analyze the effect of dexmedetomidine on the occurrence of delirium after cardiac surgery in elderly patients.Methods:Ninety-six elderly patients undergoing cardiac surgery under general anesthesia were selected and randomly divided into a control group and an observation group with 48 cases each.After the operation,pump therapy was performed with haloperidol and propofol in the control group and dexmedetomidine in the observation group.The incidence and duration of delirium,the proportion of patients achieving sedation goals,the duration of drug use and ICU stay and total hospitalization and the incidence of adverse events were compared between the two groups.Results:The incidence and duration of delirium were significantly lower,the proportion achieving sedation goals in the primary period was significantly higher,and the duration of treatment with sedative drugs and the incidence of adverse reactions were less in the observation group than in the control group in 7 day after operation(all P<0.05).Conclusion:Dexmedetomidine can effectively reduce the incidence of delirium after cardiac surgery and the time for the use of sedative drugs,shorten the duration of delirium,is beneficial to the recovery of patients and worthy of clinically further trial.