麻醉诱导前应用右美托咪定对老年妇科腹腔镜手术患者术后认知功能的影响

doi:10.3969/j.issn.1671-7171.2026.05.015

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摘要 【目的】探讨麻醉诱导前应用右美托咪定(Dex)对老年妇科腹腔镜手术患者术后认知功能的影响。【方法】行妇科腹腔镜手术的88例老年患者,随机分为观察组和对照组,每组44例。麻醉诱导前,观察组患者予以0.5 μg/kg的Dex,对照组给予等量生理盐水输注。比较两组围术期指标,用药前(T₀)、用药后30 min(T₁)、拔管前10 min(T₂)、拔管后10 min(T₃)时的舒张压(DBP)、收缩压(SBP)、心率(HR)及去甲肾上腺素(NE)、肾素活性水平,手术前后简易智能精神状态检查量表(MMSE)评分、视觉模拟评分法(VAS)评分及不良反应发生情况。【结果】两组手术时间和麻醉时间及术中失血量、补液量比较,差异均无统计学意义(P>0.05);观察组苏醒躁动程度评分(RS)低于对照组(P<0.05)。两组患者在T₁、T₂、T₃时SBP、DBP、HR比较,差异有统计学意义(P<0.05)。两组患者NE、肾素活性水平在T₂时和T₃时比较,差异有统计学意义(P<0.05)。两组患者术后3 d的VAS评分均低于术后1 d(P<0.05),且观察组低于对照组(P<0.05);对照组术后MMSE评分低于术前和观察组术后(P<0.05)。两组患者不良反应总发生率比较,差异无统计学意义(P>0.05)。【结论】Dex用于行妇科腹腔镜手术老年患者麻醉诱导前,可降低术后认知障碍发生风险,减少术后不良反应发生,具有较高的安全性。

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	耿凤新
	刘媛媛
	李继峰

关键词 ：腹腔镜检查, 妇科外科手术, 右美托咪啶, 麻醉, 认知, 老年人

Abstract：【Objective】 To investigate the effect of dexmedetomidine (Dex) administered before anesthesia induction on postoperative cognitive function in elderly patients undergoing gynecological laparoscopic surgery. 【Methods】 A total of 88 elderly patients scheduled for gynecological laparoscopic surgery were randomly divided into an observation group and a control group, with 44 patients in each group. Before anesthesia induction, the observation group received 0.5 μg/kg Dex, while the control group received an equal volume of normal saline. Perioperative indicators were compared between the two groups. Diastolic blood pressure (DBP), systolic blood pressure (SBP), heart rate (HR), norepinephrine (NE), and renin activity were measured before administration (T₀), 30 min after administration (T₁), 10 min before extubation (T₂), and 10 min after extubation (T₃). Mini-Mental State Examination (MMSE) scores, Visual Analogue Scale (VAS) scores, and the incidence of adverse reactions were recorded before and after surgery. 【Results】 There were no statistically significant differences between the two groups in operation time, anesthesia time, intraoperative blood loss, or fluid infusion volume (P>0.05). The awakening agitation score (RS) in the observation group was lower than that in the control group (P<0.05). Significant differences were observed in SBP, DBP, and HR at T₁, T₂, and T₃ between the two groups (P<0.05). NE and renin activity levels at T₂ and T₃ also showed significant differences between the two groups (P<0.05). VAS scores at postoperative day 3 were lower than those at postoperative day 1 in both groups (P<0.05), and the VAS scores in the control group were higher than those in the observation group (P<0.05). The postoperative MMSE score in the control group was lower than that before surgery of the control group and it was lower than that in the observation group after surgery (P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). 【Conclusion】 Administration of Dex before anesthesia induction in elderly patients undergoing gynecological laparoscopic surgery can reduce the risk of postoperative cognitive dysfunction and postoperative adverse reactions, with good safety.

Key words： Laparoscopy Gynecologic Surgical Procedures Dexmedetomidine Anesthesia Cognition Aged

收稿日期: 2024-10-13

中图分类号:

R713

引用本文:

耿凤新, 刘媛媛, 李继峰. 麻醉诱导前应用右美托咪定对老年妇科腹腔镜手术患者术后认知功能的影响[J]. 医学临床研究, 2026, 43(5): 758-761.
GENG Fengxin, LIU Yuanyuan, LI Jifeng. Effect of Dexmedetomidine Administered before Anesthesia Induction on Postoperative Cognitive Function in Elderly Patients Undergoing Gynecological Laparoscopic Surgery. JOURNAL OF CLINICAL RESEARCH, 2026, 43(5): 758-761.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2026.05.015 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2026/V43/I5/758

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