医学临床研究
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医学临床研究  2019, Vol. 36 Issue (7): 1297-1299    DOI: 10.3969/j.issn.1671-7171.2019.07.017
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右美托咪定麻醉对老年结直肠癌根治术患者术后认知功能及血流动力学的影响
蒋蓉娟, 孙燕, 刘少星, 朱波, 谢先丰
四川省成都市第二人民医院麻醉科,四川 成都 610016
Effect of Dexmedetomidine Anesthesia on Postoperative Cognitive Function and Hemodynamic Parameters in Elderly Patients undergoing Radical Resection of Colorectal Cancer
JIANG Rong-juan, SUN Yan, LIU Shao-xing,et al
Chengdu second people's Hospital ,SichuanChengdu,610016
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摘要 【目的】探讨右美托咪定(Dex)麻醉对老年结肠癌根治术患者术后认知功能及血流动力学指标的影响。【方法】108例直肠癌老年患者,随机分为观察组(55例)和对照组(53例)。观察组麻醉诱导后15 min内静脉泵注Dex 1.0 μg/kg,随后以0.6 μg/(kg?h)速率输注至手术结束前30 min,对照组输注等容量生理盐水。比较两组患者麻醉诱导前、诱导后、拔管时、拔管后两组患者应激反应、血流动力学变化及麻醉前、麻醉后6 h、12 h、24 h及72 h患者认知功能和术后认知障碍(POCD)发生率。【结果】观察组麻醉后应激水平显著低于麻醉前,麻醉后两组患者各时间段指数比较差异有显著性(P<0.05);观察组患者麻醉后各时间段心率、血压水平显著低于麻醉前,观察组患者麻醉各时间段血流动力学指数显著优于对照组(P<0.05)。麻醉后6 h、12 h、24 h观察组患者MMSE评分均显著优于对照组(P<0.05),麻醉后72 h两组MMSE评分相比较差异无显著性(P>0.05)。麻醉后6 h、12 h观察组POCD发生率显著低于对照组(P<0.05)。【结论】Dex麻醉有利于稳定直肠癌切除术老年患者麻醉诱导期的应激反应及血流动力学变化,并促进术后认知功能恢复,降低POCD发生率,值得临床运用。
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关键词 右美托咪定/治疗应用结直肠肿瘤/外科学认知    
Abstract【Objective】To investigate the effect of dexmedetomidine(Dex) anesthesia on postoperative cognitive function and hemodynamic parameters in elderly patients undergoing radical resection of colorectal cancer. 【Methods】A total of 108 elderly patients with colorectal cancer were divided into two groups, the observation group (n=55) and the control group (n=53). Dex was infused at a rate of 0.6μg/(kg?h) until 30 min before the end of surgery after a loading dose of Dex 1.0 μg/kg was infused at 15 min after anesthesia induction in the observation group, while the control group received equal volume of normal saline. The stress response and hemodynamic changes of the two groups were compared before, after, during and after extubation . The incidence of cognitive function and cognitive impairment (POCD) were compared between groups before anesthesia as well as 6h, 12h, 24h and 72h after anesthesia. 【Results】After anesthesia, the stress level of the observation group was lower than that before anesthesia (P<0.05). The index of the two groups was significantly different (P<0.05).The heart rate, blood pressure, and left ventricular ejection fraction index of the observation group were significantly decreased after anesthesia. The hemodynamic index of the observation group was significantly better than that of the control group (P<0.05). The cognitive function MMSE scores of the observation group was significantly better than those of the control group at 6h, 12h, and 24h after anesthesia (P<0.05). There was no significant difference in the MMSE scores between the two groups at the 72h after anesthesia (P>0.05); The incidence of COPD in the observation group was significantly lower than that in the control group at 6h and 12h after anesthesia (P<0.05). 【Conclusion】The Dex anesthesia is beneficial to stabilize the stress response and hemodynamic changes during anesthesia induction period in elderly patients undergoing rectal cancer resection. It also promotes postoperative cognitive function recovery, which is worthy of clinical promotion.
Key wordsDexmedetomidine/TU    Colorectal Neoplasms/SU    Cognition
收稿日期: 2018-06-06     
PACS:  R735.35  
基金资助:四川省医学会课题(编号:S17008)
通讯作者: E-mail:f63@sina.cn   
引用本文:   
蒋蓉娟, 孙燕, 刘少星, 朱波, 谢先丰. 右美托咪定麻醉对老年结直肠癌根治术患者术后认知功能及血流动力学的影响[J]. 医学临床研究, 2019, 36(7): 1297-1299.
JIANG Rong-juan, SUN Yan, LIU Shao-xing,et al. Effect of Dexmedetomidine Anesthesia on Postoperative Cognitive Function and Hemodynamic Parameters in Elderly Patients undergoing Radical Resection of Colorectal Cancer. JOURNAL OF CLINICAL RESEARCH, 2019, 36(7): 1297-1299.
链接本文:  
http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2019.07.017     或     http://journal07.magtech.org.cn/yxlcyj/CN/Y2019/V36/I7/1297
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