摘要
目的探讨不同剂量右美托咪定用于老年高血压患者全麻诱导期对血流动力学及认知功能的影响。方法选取2020年1月至2021年1月我院收治的300例老年高血压患者为研究对象,根据随机数字表法将其分为A组和B组,各150例。A组予以右美托咪定0.2μg/kg,B组予以右美托咪定0.6μg/kg。比较两组的血流动力学指标、应激反应指标、认知功能评分、术后苏醒质量及不良反应发生情况。结果T_(1)、T_(2)、T_(3)、T_(4)时,两组的DBP、SBP、MAP及HR均较T0时明显降低(P<0.05)。T_(1)、T_(2)、T_(3)、T_(4)时,两组的皮质醇、肾上腺素、去甲肾上腺素水平均较T0时明显升高(P<0.05)。术后1、3、5 d,A组的MMSE评分高于B组(P<0.05)。A组的苏醒时间、拔管时间及意识恢复时间均短于B组(P<0.05)。A组的心动过缓、高血压发生率低于B组,差异具有统计学意义(P<0.05)。结论临床在老年高血压患者全麻诱导期应用0.2μg/kg或0.6μg/kg右美托咪定均能维持血流动力学稳定,减轻应激反应,但0.2μg/kg的右美托咪定对改善患者术后认知功能更有利,也能提高苏醒质量,降低不良反应发生风险。
Objective To explore the effects of different doses of dexmedetomidine on hemodynamics and cognitive function in elderly patients with hypertension during general anesthesia induction.Methods A total of 300 elderly patients with hypertension treated in our hospital from January 2020 to January 2021 were selected as the research objects.According to random number table method,the patients were divided into group A and group B,with 150 cases in each group.The group A was given dexmedetomidine with 0.2μg/kg,and the group B was given dexmedetomidine with 0.6μg/kg.The hemodynamics indexes,stress response indexes,cognitive function score,postoperative awakening quality and accurrence of adverse reactions were compared between the two groups.Results At T_(1),T_(2),T_(3) and T_(4),DBP,SBP,MAP and HR in the two groups were significantly lower than those at T0(P<0.05).At T_(1),T_(2),T_(3) and T_(4),the levels of cortisol,epinephrine and norepinephrine in the two groups were significantly higher than those at T0(P<0.05).At 1,3 and 5 d after operation,the MMSE score in the group A was higher than that in the group B(P<0.05).The recovery time,extubation time and consciousness recovery time of the group A were shorter than those of the group B(P<0.05).The incidences of bradycardia and hypertension in the group A were lower than those in the group B,and the differences were statistically significant(P<0.05).Conclusion Clinical application of 0.2μg/kg or 0.6μg/kg of dexmedetomidine in elderly patients with hypertension during general anesthesia induction can maintain hemodynamics stability and reduce stress response,but 0.2μg/kg of dexmedetomidine is more beneficial to improve the cognitive function of patients after operation and the awakening quality,and reduce the risk of adverse reactions.
作者
刘小勇
王志勉
王军
LIU Xiaoyong;WANG Zhimian;WANG Jun(Mian County Hospital,Hanzhong 724200;the Second Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712000,China)
出处
《临床医学研究与实践》
2022年第5期19-22,共4页
Clinical Research and Practice
基金
陕西省中医药管理局2017-2018年度中医药科研中标项目(No.LCMS016)。
关键词
右美托咪定
高血压
全麻诱导期
血流动力学
认知功能
苏醒质量
dexmedetomidine
hypertension
general anesthesia induction
hemodynamics
cognitive function
awakening quality
