术后使用右美托咪定对老年髋部手术患者发生谵妄的临床研究

目的探讨术后使用右美托咪定对老年髋部手术患者发生谵妄的影响。 方法前瞻性收集2016年1月至2018年1月在海门市人民医院骨科行髋部手术的老年患者50例，采用随机数字表法将患者分为两组：右美托咪定组25例，术后在骨科常规治疗基础上给予右美托咪定静脉泵入注射用于术后镇痛，维持量0.5 μg/kg/hr；对照组25例，仅给予骨科常规治疗。比较两组谵妄的发生率、发生时间、持续时间。 结果全部患者均获得随访，随访时间为7~15 d，平均（10.0±1.4）d。右美托咪定组谵妄的发生率（6%）与对照组（13%）比较，差异无统计学意义（P>0.05）。右美托咪定组谵妄的发生时间为术后（26±6）h，晚于对照组的（7±3）h，差异有统计学意义（t=2.370，P<0.05）。右美托咪定组谵妄的持续时间为（2.4±0.8）d，短于对照组的（6.2±1.5）d，差异有统计学意义（t=-1.942，P<0.05）。 结论右美托咪定能延缓谵妄的发生，缩短谵妄的持续时间，但不能显著降低谵妄的发生率。

Clinical study of dexmedetomidine on postoperative delirium in elderly patients following hip surgery

ObjectiveTo explore the effect of dexmedetomidine on postoperative delirium in elderly patients following hip surgery. MethodsFifty patients over 65 years following hip surgery were admitted from January 2016 to to January 2018, they were randomly divided into two groups: dexmedetomidine group (n=25) which was given dexmedetomidine for postoperative analgesia with a does of 0.5 μg/kg/hr followed by orthopedic routine treatment and control group (n=25) which was only given with routine treatment. The incidence, onset time and duration of delirium were compared between two groups. ResultsAll patients were well followed up with a mean duration of (10.0±1.4) days (range, 7-15 days). There was no statistical difference between dexmedetomidine group (6%) and control group (13%) on the incidence of delirium (P>0.05). There was significant difference between dexmedetomidine group [(26±6) h] and control group [(7±3) h] on the onset time of delirium (t=2.370, P<0.05). There was significant difference between dexmedetomidine group [(2.4±0.8) d] and control group [(6.2±1.5) d] on the duration of delirium (t=-1.942, P<0.05). ConclusionDexmedetomidine could delay the onset time and shorten the duration of delirium, but could not lower the incidence of delirium.