右美托咪定对全麻下髋关节置换术术后认知功能的影响

目的：探讨右美托咪定对全身麻醉下髋关节置换术术后老年患者认知功能的影响，为全身麻醉下髋关节置换术辅助用药的选择提供依据。方法选择于我院择期行髋关节置换手术的老年患者72例，分为观察组和对照组，每组36例。观察组在术前给予右美托咪定辅助全身麻醉患者的镇静，然后两组皆给予全身麻醉下髋关节置换术和相应常规处理，并通过简易精神状态量表（mini-mental state examination，MMSE）评估患者认知功能的改变以及认知功能障碍的发生率。结果观察组与对照组患者在体液量、手术时间、麻醉时间等方面无显著统计学差异（P＞0.05）。在术后S100蛋白含量方面差异有统计学意义（P＜0.05）。在术后第1天、第7天的MMSE评分存在统计学差异。术后第3天，对照组认识功能障碍的发生率为27.78%（10/36），观察组认识功能障碍的发生率为19.45%（7/36），两组间存在统计学差异（P＜0.05）。术后第9天，两组患者认知能力均有部分恢复，对照组发生率为16.67%（6/36），观察组发生率为8.3%（3/36），两组间存在统计学差异（P＜0.05）。结论研究发现右美托咪定具有明显的镇静作用，能够帮助改善老年患者全身麻醉下髋关节置换术后的认知功能障碍。

Influence of dexmedetomidine on postoperative cognitive function after hip replacement surgery under general anesthesia

Objective To study the influence of dexmedetomidine on the elderly patients＂postoperative cognitive function after the hip replacement surgery under general anesthesia in order to provide reference for the selection of adjuvant drugs in the hip replacement surgery under general anesthesia. Methods Seventy-two elderly patients who received selective hip replacement surgery in our hospital were selected and divided into the observation group and the control group, with 36 patients in each group. The observation group was given dexmedetomidine before the surgery for the purpose of adjuvant sedation of the patients receiving general anesthesia and then both groups were given the hip replacement surgery under general anesthesia and relevant conventional treatment.The mini-mental state examination（MMSE） was used to evaluate the patients＂cognitive function changes and the incidences of cognitive dysfunction. Results The observation group and the control group were not significantly different in the body fluid volume,surgical time and anesthetic time（P〉0.05）,but were significantly different in the postoperative S100 protein content（P〈0.05） and were significantly different in the postoperative 1-day and 7-day MMSE scores. On day 3 after the surgery,the incidence of cognitive dysfunction of the control group was 27.78%（10/36） and that of the observation group was 19.45%（7/36）,with statistical significance between the two groups（P〈0.05）.On day 9 after the surgery,the cognitive function of both groups recovered partially;The incidence of the control group was 16.67%（6/36） and that of the observation group was 8.3%（3/36）,with statistical significance between the two groups （P〈0.05）. Conclusion The study finds that dexmedetomidine has obvious sedation effect and can help improve the elderly patients＆#39;postoperative cognitive dysfunction after the hip replacement surgery under general anesthesia.