七氟烷与右美托咪定对行全子宫切除术患者的麻醉效果及认知功能的影响

Effects of Sevoflurane and Dexmedetomidine on Anesthetic Effects and Cognitive Function in Patients Undergoing Total Hysterectomy

目的:研究七氟烷与右美托咪定对行全子宫切除术患者的麻醉效果及认知功能的影响。方法:选取2019年1月—2020年2月在蚌埠医学院第一附属医院行全子宫切除术的100例患者,按照完全随机法将患者分为对照组、研究组,各50例。两组术前均常规治疗。对照组给予七氟烷,研究组给予七氟烷复合右美托咪定。检测两组麻醉前(T0)、术后即刻(T_(1))、术后6 h(T_(2))、术后1 d(T_(3))的心率(HR)、平均动脉压(MAP)、收缩压(SBP)、皮质醇、去甲肾上腺素、血糖水平。统计简易智力状态检查(MMSE)评分、术后认知功能障碍(POCD)发生率、改良镇静-躁动评分(RASS)、自主呼吸恢复时间、苏醒时间及不良反应发生率。结果:研究组T_(1)、T_(2)、T_(3)时点HR、MAP及SBP水平均低于对照组(P<0.05)。研究组T_(1)、T_(2)、T_(3)时点皮质醇、去甲肾上腺素及血糖水平均低于对照组(P<0.05)。研究组术后MMSE评分高于对照组,POCD发生率低于对照组(P<0.05)。研究组RASS、自主呼吸恢复时间及苏醒时间均低于对照组(P<0.05)。与对照组相比,研究组不良反应发生率较低(P<0.05)。结论:七氟烷复合右美托咪定对行全子宫切除术患者的麻醉效果显著,维持血流动力稳定,提高患者术后认知功能恢复能力,降低应激反应,具有较好的安全性。

Objective:To investigate the anesthesia effect of Sevoflurane and Dexmedetomidine on patients undergoing total hysterectomy and the effect on patients'cognitive function.Method:A total of 100 patients who underwent the total hysterectomy in the First Affiliated Hospital of Bengbu Medical College from January 2019 to February 2020 were selected,and the patients were divided into the control group and the research group according to a completely randomized method,50 cases in each group.Patients in both groups were treated routinely before the operation;patients in the control group were given Sevoflurane;patients in the research group were given Sevoflurane combined with Dexmedetomidine.The heart rate(HR),mean pulse pressure(MAP),systolic blood pressure(SBP),cortisol,norepinephrine,blood glucose levels of two groups were detected before anesthesia(T0),immediately after operation(T_(1)),6 h after operation(T_(2))and 1 day after operation(T_(3)).The mini-mental state examination(MMSE)scores,incidence of postoperative cognitive dysfunction(POCD),modified richmond agitation-sedation scores(RASS),spontaneous breath recovery time,wake-up time and incidence of adverse reactions were counted.Result:The levels of HR,MAP,and SBP at T_(1),T_(2) and T_(3) in the research group were lower than those of the control group(P<0.05).The cortisol,norepinephrine and blood glucose levels at T_(1),T_(2) and T_(3) in the research group were lower than those in the control group(P<0.05).The MMSE score after operation in the research group was higher than that in the control group,and the incidence of POCD in the research group was lower than that in the control group(P<0.05).The RASS,spontaneous respiration recovery time and wake-up time of the research group were lower than those of the control group(P<0.05).Compared with the control group,the research group had a lower incidence of adverse reactions(P<0.05).Conclusion:Sevoflurane combined with Dexmedetomidine has a significant anesthesia effect on patients undergoing total hysterectomy,maintains stable blood flow,improves patients'ability to recover postoperative cognitive function,reduces stress response,and has good safety.