不同剂量右美托咪定对老年患者术后谵妄的影响研究

发布时间：2018-04-12 14:40

本文选题：谵妄 + 术后　；参考：《中国全科医学》2016年S1期

【摘要】：目的探讨不同剂量右美托咪定对老年患者术后谵妄的影响。方法选取在上海市嘉定区中心医院接受全身麻慣下择期髋部骨折手术的老年患者90例,随机分为A、B、C3组,各30例。A组患者在全身麻醉诱导前静脉泵注0.5μg/kg右美托咪定,B组患者静脉泵注0.3μg/kg,C组患者静脉泵注等量0.9%氯化钠溶液。记录3组患者心动过缓发生率、术中低血压发生率、术中出血量、手术时间、术中异丙酚和芬太尼用量、老年谵妄测验(CAMCR)评分。结果3组患者术中心动过缓发生率、术中低血压发生率、术中出血量、手术时间比较,差异无统计学意义(P0.05)。3组患者术中异丙酚和芬太尼用量比较,差异有统计学意义(P0.05)。3组患者谵妄发生率比较,差异有统计学意义(P0.05)。手术前后3组患者CAM-CR评分比较,差异有统计学意义(P0.05);不同时间点比较,差异有统计学意义(P0.05);右美托咪定用量和时间在CAM-CR评分上存在交互作用(P0.05)。结论0.5μg/kg的右美托咪定能n少老年患者术后谵妄发生率,0.3μg/kg的右美托咪定能降低CAM-CR评分。
[Abstract]:Objective to investigate the effect of dexmetidine on postoperative delirium in elderly patients.Methods A total of 90 elderly patients undergoing elective hip fracture surgery under general anesthesia in Jiading District Central Hospital of Shanghai were randomly divided into three groups.30 patients in group A received 0.5 渭 g/kg dexmetidine by intravenous pump before induction of general anesthesia. Group B received 0.3 渭 g 路kg ~ (-1) C of sodium chloride solution.The incidence of bradycardia, the incidence of intraoperative hypotension, the amount of intraoperative bleeding, the time of operation, the dosage of propofol and fentanyl during operation, and the score of CAMCRs in senile delirium were recorded.Results there was no significant difference in the incidence of bradycardia, the incidence of intraoperative hypotension, the amount of blood loss during operation and the time of operation in the three groups. There was no significant difference in the dosage of propofol and fentanyl between the three groups.The difference was statistically significant in the incidence of delirium in group P0.053.The difference was statistically significant (P 0.05).There were significant differences in CAM-CR scores between the three groups before and after operation, there were significant differences at different time points (P 0.05), and there was interaction between the dosage and time of dexmetomidine on CAM-CR score (P 0.05).Conclusion 0.5 渭 g/kg dexmetidine can decrease the CAM-CR score in elderly patients with less delirium incidence and 0.3 渭 g/kg dexmetomidine.
【作者单位】：上海市嘉定区中心医院麻醉科;
【基金】：上海市嘉定区卫生局青年科研基金项目(QNKYJJ2012-12-01) 上海市医学重点专科建设基金资助项目(ZK2012B19)
【分类号】：R614

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