术中辅用右美托咪定与咪达唑仑对术后认知功能障碍的影响比较

目的 比较术中辅用右美托咪定与咪达唑仑对术后认知功能障碍的影响.方法 选取2011年2月～2011年12月在某院行腹部全麻手术的老年患者100例为研究对象,随机分为Y组(右美托咪定组)50例和M组(咪达唑仑组)50例,比较两种麻醉药物对老年患者手术后认知功能障碍的影响.结果 Y组发生术后认知障碍的患者比例为2.0％、停麻醉药后0 min OAA/S评分为(3.30±0.24)分、5 min评分为(2.54±0.36)分、10 min评分为(1.83±0.18)分均明显低于M组；术后d 1 MMSE评分为(25.24±2.34)分、3 d MMSE评分为(25.79±2.34)分、5 d MMSE评分为(26.01±2.62)分,均明显高于M组；以上差异均具有统计学意义(P＜0.05).术前1 d MMSE评分为(26.31±2.24)分、术后7 d MMSE评分为(26.33±2.73)分,与M组差异无统计学意义(P＞0.05).结论 右美托咪定能够显著的降低麻醉药物对手术后认知功能障碍的影响,可以在手术麻醉过程中推广应用此种麻醉药物.

Comparison of the effect of application of Dexmedetomidine and Midazolam in postoperative cognitive dysfunction

OBJECTIVE To compare the effect of Dexmedetomidine and Midazolam in postoperative cognitive dysfunction.METHODS 100 cases of elderly patients with anesthesia abdomen surgery from February 2011 to December 2011 were chosen as the research subjects.They were randomly divided into the Y group(of dexmedetomidine fixed group)of 50 cases and group M(microphone alprazolam group)of 50 cases.The effects of two kinds of narcotic drugs on cognitive dysfunction in elderly patients after surgery were compared.RESULTS The proportion of patients with postoperative cognitive impairment in the Y group was 2.0%.The OAA/S score immediately after stopping the anesthetic was(3.30 ± 0.24),score in 5 minutes after stopping the anesthetic was(2.54 ± 0.36),score in 10 minutes was(1.83 ± 0.18),they were all significantly lower than the control group.MMSE score 1 day after surgery was(25.24 ± 2.34),MMSE score 3 days was(25.79 ± 2.34),MMSE score 5 days was(26.01 ± 2.62),they were all significantly higher than the M group.These differences were statistically significant(P﹤0.05).On the preoperative 1 day,MMSE score was(26.31 ± 2.24),MMSE score 7 days after surgery was(26.33 ± 2.73).There was no significant difference with group M,P﹥0.05.CONCLUSION Dexmedetomidine can significantly reduce the impact of anesthetic agents on postoperative cognitive dysfunction,and such narcotic drugs can be promoted in the process of anesthesia.