右美托咪定对老年患者腹腔镜宫颈癌根治术后谵妄的预防效果

The preventive effect of dexmedetomidine on delirium in elderly patients after laparoscopic radical resection of cervical cancer

目的探究右美托咪定对老年患者腹腔镜宫颈癌根治术后谵妄的预防效果。方法选取2019年5月至2020年4月本院收治的72例腹腔镜宫颈癌根治术老年患者作为研究对象,采用随机数字表法分为研究组和对照组,每组36例。术前,对照组静脉注射0.9%氯化钠溶液,研究组外周静脉输注右美托定,比较两组术后谵妄发生率、术前及术后6 h血清肿瘤坏死因子-α(TNF-α)、神经元特异性烯醇化酶(NES)、中枢神经特异性蛋白(S100β)水平、术前及术后生命体征(血氧饱和度、心率、舒张压、收缩压)。结果术后,研究组谵妄发生率为8.33%,明显低于对照组的33.33%(P<0.05)。术前,两组血清TNF-α、NES、S100β蛋白水平比较差异无统计学意义;术后6 h,研究组TNF-α、NES、S100β蛋白水平均明显高于对照组(P<0.05)。术前,两组血氧饱和度、心率、舒张压、收缩压比较差异无统计学意义;术后,两组血氧饱和度比较差异无统计学意义,研究组心率、舒张压、收缩压均明显低于对照组(P<0.05)。结论右美托咪定对老年患者腹腔镜宫颈癌根治术后谵妄的预防效果显著,可明显减少谵妄的发生,保证患者血流动力学稳定,值得临床推广应用。

Objective To investigate the preventive effect of dexmedetomidine on delirium in elderly patients after laparoscopic radical resection of cervical cancer.Methods 72 elderly patients with laparoscopic radical resection of cervical cancer who were treated in our hospital from May 2019 to April 2020 were selected as the research subjects,and they were divided into study group and control group according to random number table method,with 36 cases in each group.Before operation,the control group was intravenously injected with 0.9%sodium chloride solution,and the study group was intravenously injected with dexmedetomidine.The incidence of postoperative delirium,serum tumor necrosis factor-α(TNF-α),neuron-specific enolase(NES)and S100βprotein levels before and 6 h after operation,and vital signs(blood oxygen saturation,heart rate,diastolic blood pressure and systolic blood pressure)before and after operation were compared between the two groups.Results After operation,the incidence of delirium in the study group was 8.33%,which was significantly lower than 33.33%in the control group(P<0.05).Before operation,there was no significant difference in serum TNF-α,NES,soluble protein-100β(S100β)levels between the two groups;6 h after s operation,the levels of TNF-α,NES and S100βprotein in the study group were significantly higher than those in the control group(P<0.05).Before operation,there was no significant difference in blood oxygen saturation,heart rate,diastolic blood pressure and systolic blood pressure between the two groups;after operation,there was no statistically significant difference in blood oxygen saturation between the two groups,the heart rate,diastolic blood pressure and systolic blood pressure in the study group were significantly lower than those in the control group(P<0.05).Conclusion Dexmedetomidine has significant preventive effect on delirium in elderly patients after laparoscopic radical resection of cervical cancer,can significantly reduce the occurrence of delirium,and ensure the stability of hemodynamics in patients,which is worthy of clinical application.