摘要
目的:探讨右美托咪定(dexmedetomidine,DEX)对老年腹腔镜胆囊切除患者认知功能及血清炎性因子的影响。方法:以本院2017年6月-2019年3月112例腹腔镜胆囊切除患者为研究对象,随机分为对照组(56例)和观察组(56例)。诱导麻醉后,对照组给予起始剂量为1.0 g/kg的生理盐水泵入,观察组以同样方法泵入DEX。采用视觉模拟评分法(visual analogue scale,VAS)评估两组疼痛程度,采用躁动评分评两组躁动发生情况,采用简易智能状态检查量表(mini-mental state examination,MMSE)评估两组认知功能,采用实验室检测技术评估两组炎性因子水平,对比两组疼痛程度、躁动发生情况、认知功能及炎性因子水平。结果:术后,观察组VAS评分(3.2±0.8)分低于对照组(3.7±1.2)分,但差异无统计学意义(P>0.05);观察组躁动发生率8.93%明显低于对照组26.79%(P<0.05)。观察组术后1、3 d MMSE评分分别为(23.6±3.1)、(24.4±2.7)分明显高于对照组(18.2±2.7)、(19.7±2.3分)(P<0.05)。术后,观察组CRP(19.83±4.35)ng/L、IL-6(27.24±5.03)ng/L水平明显低于对照组(46.21±8.22)、(41.83±7.21)ng/L(P<0.05)。结论:右美托咪定能够降低老年腹腔镜胆囊切除患者疼痛程度,改善患者躁动发生情况及认知功能,并降低炎性因子水平。
Objective:To investigate the effects of Dexmedetomidine on cognitive function and serum inflammatory factors in elderly patients with laparoscopic cholecystectomy.Method:A total of 112 patients undergoing laparoscopic cholecystectomy in our hospital from June 2017 to March 2019 were randomly divided into a control group (56 cases) and an observation group (56 cases).After induction of anesthesia,the control group was pumped in initial dose of 1.0 g/kg of normal saline,and the observation group was pumped into DEX in the same way.The visual analogue scale (VAS) was used to assess the pain of the two groups,the restlessness score was used to assess the occurrence of restlessness in the two groups and a mini-mental state examination scale (MMSE) was used to evaluate the cognitive function of two groups,and the level of inflammatory factors was evaluated using laboratory testing techniques.The pain levels,agitation situation,cognitive function and levels of inflammatory factors were compared between the two groups.Result:After operation,the VAS score in the observation group was (3.2±0.8) points lower than that in the control group (3.7±1.2) points,but the difference was not statistically significant (P>0.05).The incidence of agitation in the observation group was 8.93% significantly lower than that in the control group of 26.79% (P<0.05).The MMSE scores in the observation group at 1 and 3 days were respectively (23.6±3.1) points and (24.4±2.7) points significantly higher than those in the control group (18.2±2.7) points and (19.7±2.3) points,the differences were statistically significant (P<0.05).After operation,the levels of CRP and IL-6 in the observation group were respectively (19.83±4.35) ng/L and (27.24±5.03) ng/L significantly lower than those in the control group of (46.21±8.22) and (41.83±7.21) ng/L,the differences were statistically significant (P<0.05).Conclusion:Dexmedetomidine can reduce the pain of elderly patients undergoing laparoscopic cholecystectomy,improve the incidence of agitation and
作者
刘健欣
邢祖民
吴东妮
王冠华
LIU Jianxin;XING Zumin;WU Dongni;WANG Guanhua(The First People’s Hospital of Shunde District,Foshan 528300,China)
出处
《中国医学创新》
CAS
2020年第28期61-64,共4页
Medical Innovation of China
基金
佛山市科学技术局医学类科技攻关计划项目(2017AB003613)。
关键词
右美托咪定
老年患者
腹腔镜胆囊切除术
认知功能
血清炎性因子
Dexmedetomidine
Elderly patients
Laparoscopic cholecystectomy
Cognitive function
Serum inflammatory factors
