摘要
目的:探讨右美托咪定鼻腔给药对改善老年患者术后认知功能的影响。方法:选择2019年10月至2021年10月南京大学医学院附属鼓楼医院收治的行全麻胸腔镜下肺叶切除术的120例老年患者。其中58例非睡眠障碍患者纳入对照组,随机分为对照A组、对照B组,各29例。对照A组手术结束前30 min经鼻分次喷入0.02 mL/kg生理盐水,对照B组手术结束前30 min经鼻分次喷入2μg/kg右美托咪定;62例睡眠障碍患者纳入研究组,随机分为研究A组、研究B组,各31例。研究A组手术结束前30 min经鼻分次喷入0.02 mL/kg生理盐水,研究B组手术结束前30 min经鼻分次喷入2μg/kg右美托咪定。对比4组术后恢复质量、疼痛程度、认知功能变化及拔管后并发症发生率。结果:对照B组术后恢复质量评分高于对照A组(P<0.05);研究B组术后恢复质量评分高于研究A组(P<0.05);对照A组术后恢复质量评分高于研究A组(P<0.05)。研究A组拔管即刻、拔管后4、8、12、24 h的视觉模拟量表(Visual Analogue Scale,VAS)评分均高于对照A组、对照B组、研究B组(均P<0.05)。研究A组术后1 d的简易智力状态检查量表(Mini-Mental State Examination,MMSE)评分低于对照A组、对照B组、研究B组(P<0.05);研究B组术后1 d的MMSE评分与对照B组相比,差异无统计学意义(P>0.05)。研究B组拔管后总并发症发生率低于研究A组(P<0.05);研究B组拔管后总并发症发生率与对照B组相比,差异无统计学意义(P>0.05)。结论:老年睡眠障碍患者术后恢复质量较差、疼痛程度严重、术后认知功能降低幅度较大,应用右美托咪定鼻腔给药可显著提高术后恢复质量,缓解疼痛程度,减轻术后认知功能障碍程度,还可减少拔管后并发症发生。
Objective: To investigate the effect of intranasal administration of dexmedetomidine on improving postoperative cognitive function in elderly patients. Methods: A total of 120 elderly patients who underwent thoracoscopic lobectomy under general anesthesia in Drum Tower Hospital Affiliated to Nanjing University School of Medicine from October 2019 to October 2021 were selected. Fi?ty-eight patients with non-sleep disorder were included in the control group and randomly divided into a control group A and a control group B, each group with 29 cases. Patients in the control group A ware sprayed with 0.02 mL/kg normal saline through the nose 30 min before the end of the operation, and patients in the control group B were sprayed with 2 μg/kg dexmedetomidine through the nose 30 min before the end of the operation. Sixty-two patients with disabilities were included in the study group and randomly divided into a study group A and a study group B, each group with 31 cases. Patients in the study group A were sprayed with 0.02 mL/kg normal saline through the nose 30 min before the end of the operation, and patients in the study group B were sprayed with 2 μg/kg dexmedetomidin through the nose 30 min before the end of the operation. The postoperative recovery quality, pain degree, cognitive function changes, and the incidence of complications after extubation were compared in the 4 groups. Results: The score of postoperative recovery quality in the control group B was higher than that in the control group A(P<0.05);the score of postoperative recovery quality in the study group B was higher than that in the study group A(P<0.05);the score of postoperative recovery quality in the control group A was higher than that in the study group A(P<0.05). The Visual Analogue Scale(VAS) scores at the moment of extubation and at 4, 8, 12, and 24 h after the extubation in the study group A were higher than those in the control group A, the control group B, and the study group B(all P<0.05). The Mini-Mental State Examination(MMSE) score o
作者
王珍珍
朱继青
WANG Zhenzhen;ZHU Jiqing(Department of Anesthesiology and Surgery,Drum Tower Hospital Affiliated to Nanjing University School of Medicine,Nanjing 210000,China)
出处
《临床与病理杂志》
CAS
2022年第12期2990-2996,共7页
Journal of Clinical and Pathological Research
基金
江苏省青年医学人才项目(QNRC2016014)。
关键词
右美托咪定
睡眠障碍
老年
认知功能
疼痛程度
并发症
dexmedetomidine
sleep disorders
elderly
cognitive function
pain level
complications
