论文部分内容阅读
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15min内静脉泵注Dex1.0μg/kg,随后以0.6μg/(kg·h)速率输注至手术结束前30min,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6h、12h、24h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6h、12h、24h观察组患者 MMSE评分均显著优于对照组(P0.05).麻醉后6h、12h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.“,”Toinvestigatetheeffectofdexmedetomidine(Dex)anesthesiaonpostoperativecogni-tivefunctionandhemodynamicparametersinelderlypatientsundergoingradicalresectionofcolorectalcancer.[Methods]Atotalof108elderlypatientswithcolorectalcancerweredividedintotwogroups,theobservation group (n=55)andthecontrolgroup (n=53).Dexwasinfusedatarateof0.6μg/(kg·h)until30minbefore theendofsurgeryafteraloadingdoseofDex1.0μg/kgwasinfusedat15minafteranesthesiainductionintheob-servationgroup,whilethecontrolgroupreceivedequalvolumeofnormalsaline.Thestressresponseandhemody-namicchangesofthetwogroupswerecomparedbefore,after,duringandafterextubation .Theincidenceofcog-nitivefunctionandcognitiveimpairment(POCD)werecomparedbetweengroupsbeforeanesthesiaaswellas6h, 12h,24hand72hafteranesthesia.[Results]Afteranesthesia,thestressleveloftheobservationgroupwaslower thanthatbeforeanesthesia(P<0.05).Theindexofthetwogroupswassignificantlydifferent(P<0.05).The heartrate,bloodpressure,andleftventricularejectionfractionindexoftheobservationgroupweresignificantly decreasedafteranesthesia.Thehemodynamicindexoftheobservationgroupwassignificantlybetterthanthatof thecontrolgroup(P<0.05).ThecognitivefunctionMMSEscoresoftheobservationgroupwassignificantlybet-terthanthoseofthecontrolgroupat6h,12h,and24hafteranesthesia(P0.05);TheincidenceofCOPD intheobservationgroupwassignificantlylowerthanthatinthecontrolgroupat6hand12hafteranesthesia(P<0.05).[Conclusion]TheDexanesthesiaisbeneficialtostabilizethestressresponseandhemodynamicchangesdur-inganesthesiainductionperiodinelderlypatientsundergoingrectalcancerresection.Italsopromotespostoperative cognitivefunctionrecovery,whichisworthyofclinicalpromotion.