摘要
目的研究盐酸右美托咪定不同给药方式对合并轻度认知障碍(mild cognitive impairment,MCI)的老年患者单侧髋关节置换术后短期认知功能的影响。方法选取120例择期行单侧髋关节置换术合并MCI的老年患者,使用数字表随机分为A组单次给药组(n=40),B组持续泵注组(n=40),C组对照组(n=40)。于术前1 d和术后7 d采用简易智力状态检查量表(MMSE)和蒙特利尔认知评估量表(MoCA)评估患者认知功能,并测定血浆载脂蛋白J(Apo J)和α-突触核蛋白(α-syn)的浓度;记录恢复自主呼吸时间、睁眼时间、拔管时间及术中不良事件。结果C组术后MMSE和MoCA评分低于术前且低于术后A、B组;术后B、C组的Apo J和A、B、C组α-syn浓度高于术前,术后血浆Apo J和α-syn浓度为C组>B组>A组。以上差异均有统计学意义(P<0.05)。其余结果差异无统计学意义(P>0.05)。结论本研究表明对合并MCI的老年患者,应用盐酸右美托咪定可以减少术后短期认知功能障碍的发生,对于本手术单次给药方式优于持续缓慢泵注。
Objective To study the effect of different administrations of dexmedetomidine hydrochloride(Dex)on short-term cognitive function in elderly patients with mild cognitive impairment(MCI)after unilateral hip replacement.Methods A total of 120 elderly patients who underwent unilateral hip arthroplasty combined with MCI were randomly divided into group A(single administration group,n=40),group B(continuous pumping group,n=40),and group C(control group,n=40).Patients′cognitive function was assessed with the Simple Mental State Examination Scale(MMSE)and the Montreal Cognitive Assessment Scale(MoCA)at 1 d preoperatively(T0)and 7 d(T1)postoperatively,and the plasma apolipoprotein J(Apo J)andα-synuclein(α-syn)concentration were determined.Respiratory recovery time,eye opening time,extubation time and intraoperative adverse events were recorded after operation.Results Postoperative MMSE and MoCA scores in group C were lower than before and lower than those in groups A and B;The concentrations of Apo J in groups B,C andα-syn in group A,B,C were higher than those before operation;Postoperative plasma Apo J andα-syn concentrations were in group C>group B>group A.The above differences were statistically significant(P<0.05).No significant difference was found in other results(P>0.05).Conclusion This trial shows that in elderly patients with MCI,the use of DEX could reduce the occurrence of short-term cognitive dysfunction after surgery,and for this procedure,single administration is preferable to continuous slow pumping.
作者
张莹莹
王云朋
杨萱
刘双双
张树波
刘铁军
ZHANG Yingying;WANG Yunpeng;YANG Xuan;LIU Shuangshuang;ZHANG Shubo;LIU Tiejun(Director of Department of Anesthesiology,North China University of Scienceand Technology Affiliated Hospital Postgraduatetutor,Tangshan 063000,China)
出处
《实用医学杂志》
CAS
北大核心
2020年第6期788-791,共4页
The Journal of Practical Medicine
基金
河北省医学科学研究重点课题计划项目(编号:20191109)
河北省教育厅高等学校研究计划(编号:QN2019199)
河北省中医药管理局中医药类科研计划课题(编号:2017202)。
关键词
右美托咪定
不同给药方式
短期术后认知功能障碍
老年患者
MCI
dexmedetomidine
different administration methods
short-term postoperative cognitive dysfunction
elderly patients
MCI
