摘要
目的探讨右美托咪定对老年骨折患者术后认知功能的影响及作用机制。方法对汉中市中医医院2015年2月—2017年6月收治的老年骨折手术患者180例的临床资料进行回顾性分析,根据麻醉方法分为观察组和对照组,每组90例。观察组静脉泵注盐酸右美托咪定,对照组泵注等量生理盐水。比较两组术中情况及术前、术后1d、术后3 d的简易智力状态检查量表(MMSE)评分、认知功能降低发生率及炎性因子水平。结果观察组术后1、3 d MMSE评分均高于对照组,认知功能降低发生率均低于对照组(P<0.05)。两组术后1、3 d白介素-6、肿瘤坏死因子-α水平均较术前升高,但观察组低于对照组(P<0.05,P<0.01)。两组术中情况及不良反应发生率比较差异无统计学意义(P>0.05)。结论在老年骨折患者手术中应用右美托咪定可减少患者术后认知功能障碍的发生,其作用机制可能与抑制炎性反应有关。
Objective To investigate effect and of Dexmedetomidine on postoperative cognitive function in elderly patients with fracture and its mechanism.Methods Clinical data of 180 elderly patients with fracture admitted during February 2015 and June 2017 was retrospectively analyzed,and the patients were divided into observation group(n=90)and control group(n=90)according to anesthesia methods.Observation group was given Dexmedetomidine Hydrochloride by venous pump,while control group received the same volume of physiological saline.Intraoperative conditions,mini-mental state examination(MMSE)scores and inflammatory factor levels before and 1d and 3d after operation,and reduction rate of cognitive function at 1d and 3d after operation were compared in two groups.Results At 1d and 3d after operation,MMSE scores were significantly higher,while reduction rate of cognitive function was significantly lower in observation group than those in control group(P<0.05).Interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)levels at 1d and 3d after operation were significantly higher than those before treatment in two groups,and the levels in observation group were significantly lower than those in control group(P<0.05,P<0.01).There were no significant differences in intraoperative conditions and incidence rate of adverse reactions in two groups(P>0.05).Conclusion Dexmedetomidine may reduce incidence rate of postoperative cognitive dysfunction in elderly patients with fracture,and its mechanism may be related to the inhibition of inflammatory reaction.
作者
石奎
柏雪燕
张艳玲
首华云
SHI Kui;BAI Xueyan;ZHANG Yanling;SHOU Huayun(Department of Anesthesiology,Hanzhoung Hospital of Traditional Chinese Medicine,Hanzhoung,Shaanxi 723100,China;Department of Gynaecology and Obstetrics,Hanzhoung Hospital of Traditional Chinese Medicine,Hanzhoung,Shaanxi 723100,China)
出处
《解放军医药杂志》
CAS
2018年第1期98-101,共4页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
陕西省卫生厅科研基金项目(2014JM42256)
关键词
右美托咪定
麻醉
老年人
认知障碍
Dexmedetomidine
Anesthesia
Aged
Cognition disorders
