右美托咪定对超高龄股骨头置换术患者术后认知功能的影响

Effect of Dexmedetomidine on Postoperative Cognitive Function in Ultrahigh-age Patients with Femoral Head Replacement

目的研究右美托咪定对超高龄股骨头置换术患者术后认知功能的影响。方法选取2020年1月—2022年1月福建省福州市第二医院收治的100例超高龄股骨头置换术患者为研究对象,随机分为对照组和观察组,各50例。对照组给予常规麻醉,观察组麻醉诱导阶段前给予盐酸右美托咪定,比较两组术后意识恢复时间、定向力恢复时间、睁眼时间、拔管时间、术后认知能力和POCD发生率。结果观察组术后意识恢复时间(10.43±2.84)min、定向力恢复时间(14.61±3.19)min、睁眼时间(8.58±2.27)min、拔管时间(6.48±2.03)min均短于对照组,差异有统计学意义(P<0.05)。观察组术后24、72 h的MMSE评分(27.78±1.27)分、(28.08±1.34)分均显著高于对照组(24.53±1.19)分、(25.65±1.47)分,差异有统计学意义(t=-13.204、-8.638,P<0.05)。观察组POCD发生率(10.0%)低于对照组,差异有统计学意义(P<0.05)。结论右美托咪定可改善超高龄股骨头置换术患者的苏醒质量和术后认知功能,降低POCD的发生率。

Objective To study the effect of dexmedetomidine on postoperative cognitive function in ultra-high-age patients with femoral head replacement.Methods From January 2020 to January 2022,100 ultra-elderly patients with femoral head replacement admitted to the Second Hospital of Fuzhou City,Fujian Province were selected as the study objects and randomly divided into a control group and an observation group,with 50 cases each.The control group was given conventional anesthesia,and the observation group was given dexmedetomidine hydrochloride before the induction phase of anesthesia.The postoperative consciousness recovery time,orientation recovery time,eye opening time,extubation time,postoperative cognitive ability and POCD incidence were compared between the two groups.Results The postoperative consciousness recovery time(10.43±2.84)min,orientation recovery time(14.61±3.19)min,eye opening time(8.58±2.27)min,extubation time(6.48±2.03)min in the observation group were shorter than those in the control group,the difference was statistically significant(P<0.05).The MMSE scores(27.78±1.27)points and(28.08±1.34)points in the observation group at 24 h and 72 h after surgery were significantly higher than those in the control group(24.53±1.19)points and(25.65±1.47)points,the difference was statistically significant(t=-13.204,-8.638,P<0.05)The POCD incidence in the observation group(10.0%)was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion Dexmedetomidine improves the quality of awakening and postoperative cognitive function and reduces the incidence of POCD in ultra-high-age femoral head replacement patients.