摘要
[目的]探讨右美托咪定应用于老年股骨转子间骨折术中的麻醉效果及对患者术后认知功能的影响.[方法]本院收治的78例老年股骨转子间骨折手术患者,随机分为两组,对照组采用丙泊酚麻醉镇静,观察组采用右美托咪定麻醉镇静.比较两组患者手术时间、镇静作用起效时间、术毕苏醒时间.比较两组患者麻醉前(T0)、麻醉后10 min(T1)、术毕(T2)、术后1 h(T3)的心率及平均动脉压;比较术前、术后3 d简易精神状态量表(MMSE)评分及血清去甲肾上腺素(NE)、皮质醇(COR)、丙二醛(MDA)、超氧化物歧化酶(SOD)水平.[结果]两组患者手术时间比较,差异无统计学意义(P＞0.05);观察组镇静作用起效时间、术毕苏醒时间均短于对照组(P＜0.05);观察组T1、T2、T3时的心率、平均动脉压低于对照组(P＜0.05).术后3 d,观察组患者的MMSE评分与术前比较,差异无统计学意义(P＞0.05);对照组患者的MMSE评分低于术前(P＜0.05);术后3 d,观察组患者的MMSE评分高于对照组(P＜0.05).术后3 d,观察组血清NE、COR、MDA、SOD水平均低于对照组(P＜0.05).[结论]右美托咪定麻醉用于老年股骨转子间骨折手术可以减轻患者认知功能损伤,且安全可靠.
Abstract
[Objective]To investigate the anesthetic effects of dexmedetomidine in elderly patients undergoing surgery for intertrochanteric femur fractures and its impact on postoperative cognitive function.[Methods]In this study,78 elderly patients undergoing surgery for intertrochanteric femur fractures were randomly divided into two groups:the control group received propofol anesthesia and sedation,while the observation group received dexme-detomidine anesthesia and sedation.Comparisons were made between the two groups in terms of surgery duration,time for sedative effect to begin,and time to recover from anesthesia;heart rate and mean arterial pressure at pre-anesthesia(T0),10 minutes after anesthesia(T1),end of surgery(T2),and 1 hour post-surgery(T3);Mini-Mental State Examination(MMSE)scores before surgery and 3 days after surgery;levels of serum norepinephrine(NE),cortisol(COR),malondialdehyde(MDA),and superoxide dismutase(SOD)before and 3 days after sur-gery.[Results]There was no significant difference in surgery duration between the two groups(P＞0.05).The onset time of sedation and recovery time after surgery in the observation group were shorter than those in the con-trol group(P＜0.05).The heart rate and mean arterial pressure at T1,T2,and T3 were lower in the observation group compared to the control group(P＜0.05).Three days post-surgery,there was no significant difference in MMSE scores in the observation group compared to pre-surgery(P＞0.05),while the control group showed a decrease in MMSE scores compared to pre-surgery(P＜0.05).The MMSE scores of 3 days post-surgery in the observation group were higher than those in the control group(P＜0.05).Three days post-surgery,the levels of serum NE,COR,MDA,and SOD in the observation group were lower than those in the control group(P＜0.05).[Conclusion]Dexmedetomidine anesthesia in elderly patients undergoing surgery for intertrochanteric femur fractures can reduce cognitive function impairment.And it is safe and reliable.
维普
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