[1]何丽姝.右美托咪定对老年股骨颈骨折手术患者术后苏醒质量及谵妄的影响[J].医学信息,2023,36(16):112-116.[doi:10.3969/j.issn.1006-1959.2023.16.021]
　HE Li-shu.Effect of Dexmedetomidine on Postoperative Recovery Quality and Delirium in Elderly Patients Undergoing Femoral Neck Fracture Surgery[J].Journal of Medical Information,2023,36(16):112-116.[doi:10.3969/j.issn.1006-1959.2023.16.021]
点击复制

右美托咪定对老年股骨颈骨折手术患者术后苏醒质量及谵妄的影响()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
36卷
期数:
2023年16期
页码:
112-116
栏目:
论著
出版日期:
2023-08-15

文章信息/Info

Title:
Effect of Dexmedetomidine on Postoperative Recovery Quality and Delirium in Elderly Patients Undergoing Femoral Neck Fracture Surgery
文章编号:
1006-1959（2023）16-0112-05
作者:
何丽姝
（天津市第四中心医院麻醉科，天津 300143）
Author(s):
HE Li-shu
(Anesthesia Department of Tianjin Fourth Central Hospital,Tianjin 300143,China)
关键词:
麻醉; 股骨颈骨折; 镇痛; 谵妄
Keywords:
Anesthesia; Femoral neck fracture; Analgesia; Delirium
分类号:
R614
DOI:
10.3969/j.issn.1006-1959.2023.16.021
文献标志码:
A
摘要:
目的 探讨右美托咪定在老年股骨颈骨折手术患者中的应用效果。方法 选择2021年1月-2022年12月我院收治的80例老年股骨颈骨折手术患者，根据随机数字表法将其分为对照组和研究组， 每组40例。两组均予以全身麻醉下行股骨颈骨折手术，对照组于麻醉诱导前经静脉泵入0.5 μg/kg生理盐水，研究组于麻醉诱导前经静脉泵入0.5 μg/kg右美托咪定。比较两组术后呼吸恢复时间、睁眼时间及拔管时间，比较两组术前、术后第3天血清P物质（SP）、去甲肾上腺素（NE）水平及简易精神状态检查表（MMSE）评分，统计患者术后谵妄及不良反应发生情况。结果 研究组术后呼吸恢复时间、睁眼时间及拔管时间均短于对照组，差异有统计学意义（P＜0.05）；两组术后第3天血清SP及NE水平均高于术前，且研究组低于对照组，差异有统计学意义（P＜0.05）；两组术后MMSE评分均低于术前，且研究组高于对照组，差异有统计学意义（P＜0.05）；研究组术后谵妄发生率低于对照组，差异有统计学意义（P＜0.05）；两组不良反应发生率比较，差异无统计学意义（P＞0.05）。结论 右美托咪定可改善老年股骨颈骨折手术患者术后苏醒质量及镇痛效果，对于患者认知功能的影响较小，可降低术后谵妄发生风险，且不会增加不良反应。
Abstract:
Objective To investigate the application effect of dexmedetomidine in elderly patients undergoing femoral neck fracture surgery.Methods A total of 80 elderly patients with femoral neck fracture treated in our hospital from January 2021 to December 2022 were selected and divided into control group and study group according to the random number table method, with 40 patients in each group. Both groups were given femoral neck fracture surgery under general anesthesia. The control group was intravenously pumped with 0.5 μg/kg normal saline before anesthesia induction, and the study group was intravenously pumped with 0.5 μg/kg dexmedetomidine before anesthesia induction. The postoperative respiratory recovery time, eye opening time and extubation time were compared between the two groups. The levels of serum substance P (SP), norepinephrine (NE) and mini-mental state examination (MMSE) scores were compared between the two groups before and 3 days after operation. The incidence of postoperative delirium and adverse reactions were statistically analyzed.Results The postoperative respiratory recovery time, eye opening time and extubation time in the study group were shorter than those in the control group, and the differences were statistically significant (P<0.05). The levels of serum SP and NE in the two groups at 3 days after operation were higher than those before operation, and those in the study group were lower than those in the control group, the differences were statistically significant (P<0.05). The MMSE score of the two groups after operation was lower than that before operation, and that in the study group was higher than that in the control group, the difference was statistically significant (P<0.05). The incidence of postoperative delirium in the study group was lower than that in the control group, the difference was statistically significant (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).Conclusion Dexmedetomidine can improve the postoperative recovery quality and analgesic effect of elderly patients undergoing femoral neck fracture surgery. Meanwhile, tt has little effect on the cognitive function of patients, can reduce the risk of postoperative delirium, and will not increase adverse reactions.

参考文献/References:

[1]战红旗,马剑雄,崔爽爽,等.三维测量嵌插型股骨颈骨折后倾角与股骨头坏死的相关性[J].中国组织工程研究,2023,27(36):5747-5752.[2]吴江红,杨桓,牛升波,等.激光定位导航系统用于辅助股骨颈骨折空心螺钉置入术的实验研究[J].海军军医大学学报,2022,43(9):1071-1075.[3]王金伙,高新跃,郭建荣.COX-2抑制剂对老年骨科手术患者术后谵妄的影响及其可能的作用机制[J].中国临床药理学与治疗学,2022,27(8):863-869.[4]焦裕霞,周群,范凯乐,等.麻醉方法与老年膝关节置换患者血清褪黑素质量浓度和苏醒期谵妄的关系[J].中国组织工程研究,2019,23(28):4468-4473.[5]陈奕关,伍堂洪,王群,等.右美托咪定复合体温保护对经皮肾镜取石术老年患者认知功能的影响[J].暨南大学学报(自然科学与医学版),2022,43(5):507-513.[6]聂宇,于健,朱春花,等.盐酸右美托咪定联合瑞芬太尼在骨科手术中的应用效果及对呼吸功能的影响[J].基因组学与应用生物学,2020,39(1):343-348.[7]俞红丽,陈明慧,孙世宇,等.右美托咪定对60岁以上骨科手术患者术后谵妄的影响[J].上海医学,2019,42(6):362-367.[8]Schupper AJ,Shuman WH,Baron RB,et al.Utilization of the American Society of Anesthesiologists (ASA) classification system in evaluating outcomes and costs following deformity spine procedures[J].Spine Deform,2021,9(1):185-190.[9]陈孝平,汪建平.外科学[M].北京:人民卫生出版社,2013:425-426．[10]张一,张瑜,王涯,等.简易精神状态检查评分正常的脑外伤患者行为记忆测评分析[J].中国康复理论与实践,2019,25(3):294-297.[11]徐杏梅,陈齐,李云,等.不同血压调控水平对老年患者髋关节置换术中局部脑氧饱和度及术后谵妄的影响[J].临床麻醉学杂志,2019,35(12):1161-1165.[12]李骏然,翟婧秀,罗程,等.直接前侧入路全髋与半髋关节置换术治疗高龄股骨颈骨折的疗效[J].实用医学杂志,2022,38(20):2602-2607.[13]李楠,纪玮玮,刘伟,等.老年病人全麻下髋关节置换术后谵妄危险因素分析[J].实用老年医学,2022,36(8):838-841.[14]钟玉婷,田克钧,郭锐,等.麻醉诱导前泵注右美托咪定对室性心律失常患者围术期左心室功能、血流动力学的影响[J].中国现代医学杂志,2022,32(22):75-79.[15]崔松勤,黄红芳,黄雪莲,等.七氟烷预处理和右美托咪定对老年食管癌患者术后认知功能的影响[J].天津医药,2021,49(10):1089-1093.[16]于文春,杨寿娟.不同剂量右美托咪定复合全身麻醉对苏醒期患者咽喉反射及苏醒质量的影响[J].中国老年学杂志,2021,41(10):2090-2093.[17]郑贤军,姜金玉,黄晓玲,等.右美托咪定用于术后镇痛对老年轻度认知功能障碍患者髋关节置换术后谵妄的影响[J].中华实验外科杂志,2022,39(6):1192-1195.[18]吴迪,李俊青,袁浩,等.右美托咪定对老年肺部手术患者术后谵妄发生率、脑氧代谢的影响[J].中国现代医学杂志,2022,32(14):71-76.[19]陈慧敏,江婷婷,贾洪峰,等.老年患者胃肠肿瘤手术后认知功能障碍的相关因素[J].临床麻醉学杂志,2022,38(6):617-621.[20]庞海涛,李小琳,李亦君,等.不同剂量右美托咪定对老年脊柱手术患者脑保护的作用[J].中国老年学杂志,2020,40(9):1878-1880.

相似文献/References:

[1]侯 江.舒芬太尼联合右美托咪定用于临床麻醉的效果观察[J].医学信息,2018,31(03):144.[doi:10.3969/j.issn.1006-1959.2018.03.051]
　HOU Jiang.Clinical Observation on the Effect of Sufendate Combined with Dexlansoprazole in Clinical Anesthesia[J].Journal of Medical Information,2018,31(16):144.[doi:10.3969/j.issn.1006-1959.2018.03.051]
[2]许天华,叶妙恩,马立靖.重症老年患者无痛胃肠镜检查麻醉效果研究[J].医学信息,2018,31(08):84.[doi:10.3969/j.issn.1006-1959.2018.08.026]
　XU Tian-hua,YE Miao-en,MA Li-jing.Study on Anesthesia Effect of Painless Gastroenteroscopy in the Elderly Patients with Severe Cases[J].Journal of Medical Information,2018,31(16):84.[doi:10.3969/j.issn.1006-1959.2018.08.026]
[3]冉会仁.小剂量舒芬太尼在剖宫产术麻醉中预防寒战及 牵拉痛的疗效评价[J].医学信息,2018,31(08):101.[doi:10.3969/j.issn.1006-1959.2018.08.032]
　RAN Hui-ren.Evaluation of the Efficacy of Low-dose Sufentanil in Preventing Chills and Pulling Pain during Cesarean Section Anesthesia[J].Journal of Medical Information,2018,31(16):101.[doi:10.3969/j.issn.1006-1959.2018.08.032]
[4]赵 立,梁永新.瑞芬太尼联合丙泊酚应用于食道异物取出术的麻醉效果分析[J].医学信息,2018,31(11):93.[doi:10.3969/j.issn.1006-1959.2018.11.028]
　ZHAO Li,LIANG Yong-xin.Analysis of Anesthetic Effect of Remifentanil Combined with Propofol for Removal of Esophageal Foreign Body[J].Journal of Medical Information,2018,31(16):93.[doi:10.3969/j.issn.1006-1959.2018.11.028]
[5]朱耀斌,张金蕊,赵宇东,等.微信在围手术期的应用现状[J].医学信息,2019,32(02):39.[doi:10.3969/j.issn.1006-1959.2019.02.014]
　ZHU Yao-bin,ZHANG Jin-rui,ZHAO Yu-dong,et al.Application Status of WeChat in Perioperative Period[J].Journal of Medical Information,2019,32(16):39.[doi:10.3969/j.issn.1006-1959.2019.02.014]
[6]王添兴,李国庆,汪 洋,等.空心加压螺钉与动力髋螺钉治疗股骨颈骨折术后股骨头坏死相关并发症的Meta分析[J].医学信息,2019,32(02):83.[doi:10.3969/j.issn.1006-1959.2019.02.024]
　WANG Tian-xing,LI Guo-qing,WANG Yang,et al.Meta-analysis of Complications Associated with Hollow Compression Screws and Dynamic Hip Screws in the Treatment of Femoral Head Necrosis after Femoral Neck Fracture[J].Journal of Medical Information,2019,32(16):83.[doi:10.3969/j.issn.1006-1959.2019.02.024]
[7]谢北琼.延续性护理对股骨颈骨折患者术后关节功能恢复和并发症的影响[J].医学信息,2022,35(10):190.[doi:10.3969/j.issn.1006-1959.2022.10.050]
　XIE Bei-qiong.Effect of Continuous Nursing on Postoperative Joint Function Recovery and Complications in Patients with Femoral Neck Fracture[J].Journal of Medical Information,2022,35(16):190.[doi:10.3969/j.issn.1006-1959.2022.10.050]
[8]刘 亮,韩建阁.右美托咪定在心血管手术麻醉中的应用[J].医学信息,2022,35(11):60.[doi:10.3969/j.issn.1006-1959.2022.11.017]
　LIU Liang,HAN Jian-ge.Application of Dexmedetomidine in Anesthesia of Cardiovascular Surgery[J].Journal of Medical Information,2022,35(16):60.[doi:10.3969/j.issn.1006-1959.2022.11.017]
[9]李树贤,李 倩.宫腔镜手术麻醉中应用右美托咪定与瑞芬太尼复合依托咪酯的效果比较[J].医学信息,2022,35(11):114.[doi:10.3969/j.issn.1006-1959.2022.11.029]
　LI Shu-xian,LI Qian.Comparison of the Effect of Dexmedetomidine and Remifentanil Combined with Etomidate in Hysteroscopic Surgery Anesthesia[J].Journal of Medical Information,2022,35(16):114.[doi:10.3969/j.issn.1006-1959.2022.11.029]
[10]杨书娇.早期康复护理对股骨颈骨折患者全髋关节置换术后功能恢复的影响[J].医学信息,2018,31(22):184.[doi:10.3969/j.issn.1006-1959.2018.22.056]
　YANG Shu-jiao.Effect of Early Rehabilitation Nursing on Functional Recovery after Total Hip Arthroplasty in Patients with Femoral Neck Fracture[J].Journal of Medical Information,2018,31(16):184.[doi:10.3969/j.issn.1006-1959.2018.22.056]

更新日期/Last Update: 1900-01-01