右美托咪定复合舒芬太尼对全子宫切除术后患者血流动力学、认知障碍的影响

Effect of Dexmedetomidine Combined with Sufentanil on Hemodynamics and Cognitive Impairment in Patients after Total Hysterectomy

讨论右美托咪定联合舒芬太尼麻醉对全子宫切除术女性患者的血流动力学和认知障碍的影响,希望为改善麻醉剂的效果提供临床证据。选取2018年6月至2020年6月共行全子宫切除术的120名中年妇女为研究对象,将其随机分为两组。观察组(60例)采用右美托咪定复合舒芬太尼麻醉,对照实验(60例)采用舒芬太尼麻醉,比较两组患者术中的一般情况,手术后的血流动力学指标值的变化、简易精神状态检查量表(MMSE)评分及认知功能障碍(POCD)的发生情况。两组患者的手术时间、麻醉时间、输液量、尿量和出血量等一般情况方面不具备显著性差异(P>0.05)。两组患者术后的T_(1)、T_(2)、T_(3)时间点与T0时间点的平均动脉压和心率比较,均有所降低(P<0.05);在术后T_(1)、T_(2)时间点,观察组(61.23±2.02、63.65±1.32)mmHg的平均动脉压较对照组(65.69±2.43、67.02±1.41)mmHg更低(P<0.05),观察组(79.67±2.67、77.98±1.39)次/分的心率较对照组(72.56±3.02、73.02±1.58)次/分更高(P<0.05);术后T_(3)、T_(4)两组的平均动脉压和心率比较,均无明显差异(P<0.05);在术后T_(1)、T_(2)、T_(3)时间点,观察组患者(23.31±1.30、26.28±`0.83、27.48±0.80)分的MMSE评分明显高于对照组(21.66±1.83、22.91±1.29、24.37±0.75)分(P<0.05),在T_(4)时间点时,两组MMSE评分之间无明显差异(P>0.05);观察组(5%)较对照组患者(20%)发生POCD的情况更少,差异具备显著性(P<0.05)。右美托咪定复合舒芬太尼麻醉剂用于中年妇女全子宫切除术,血流动力学稳定,POCD发生率低,安全有效,可用于临床。

This paper discussed the effect of dexmedetomidine combined with sufentanil anesthesia on hemodynamics and cognitive impairment in female patients undergoing total hysterectomy,hoping to provide clinical evidence for improving the effect of anesthetics.A total of 120 middle-aged women who underwent total hysterectomy from June 2018 to June 2020 were selected as the study subjects,and they were randomized into two groups.The observation group(60 cases)was anesthetized with dexmedetomidine combined with sufentanil,and the control experiment(60 cases)was anesthetized with sufentanil.The general conditions of the two groups during the operation and the hemodynamic indexes after the operation,the Mini Mental State Examination Scale(MMSE)score,and the occurrence of cognitive dysfunction(POCD)were compared.There was no significant difference between the two groups of patients in general conditions such as operation time,anesthesia time,infusion volume,urine volume and bleeding volume(P>0.05).The average arterial pressure and heart rate at the T_(1),T_(2),and T_(3)time points after the operation of the two groups of patients were compared with the T0time point,and the average arterial pressure and heart rate were reduced(P<0.05).At T_(1)and T_(2)time points after surgery,the mean arterial pressure of the observation group(61.23±2.02,63.65±1.32)mmHg was lower than that of the control group(65.69±2.43,67.02±1.41)mmHg(P<0.05),and the heart rate of observation group(79.67±2.67,77.98±1.39)bmp was higher than that of the control group(72.56±3.02,73.02±1.58)bmp(P<0.05).There was no significant difference in the mean arterial pressure and heart rate at the T_(3)and T_(4)time points between two groups after surgery(P<0.05).At T_(1),T_(2),and T_(3)time points after surgery,the MMSE scores of patients in the observation group(23.31±1.30,26.28±0.83,27.48±0.80)were significantly higher than those of the control group(21.66±1.83,22.91±1.29,24.37±0.75)(P<0.05).At T_(4)time point,there was no significant difference between the two groups of MMSE scores(P>0.05).The observation group(5%)had fewer cases of POCD than the control group(20%),and the difference was significant(P<0.05).Dexmedetomidine combined with sufentanil anesthetic for total hysterectomy in middle-aged women has stable hemodynamics,low incidence of POCD,safe and effective,and can be used in clinical applications.