右美托咪定对老年患者经尿道前列腺电切术后认知障碍的影响

摘要

目的：研究右美托咪定（DEX）改善经尿道前列腺电切手术后认知障碍的作用。方法：选取2008年1月至2012年12月，经尿道前列腺电切术后出现认知障碍的患者70例分为两组。观察组（n＝35）患者麻醉成功后给予DEX，对照组（n＝35）给予同等剂量生理盐水。对两组患者心率、平均动脉压、呼吸频率、血氧饱和度等进行观察，并进行精神状态、舒适度、镇静效果、应激因素等评分，比较两组患者不同时段的生命体征、情绪波动和手术后不良反应。结果：观察组患者不同时间点生命体征情况明显优于对照组，DEX干预下患者寒战反应降低，明显提高了舒适度。内科疾病、麻醉因素、脑缺氧对术后认知障碍有一定影响。结论：DEX对老年患者经尿道前列腺电切术后的认知障碍具有良性影响。%OBJECTIVE:To study the efficacy of dexmedetomidine(DEX)for improving cognitive impairment in patients af-ter transurethral resection of prostate. METHODS:A total of 70 patients with cognitive impairment after transurethral resection of prostate from Jan. 2008 to Dec. 2012 were randomized to two groups of 35 cases each. The observation group was given dexmedeto-midine after success of anesthesia while the control group was given the same dose of normal saline. The indexes including heart rate,mean arterial pressure,respiratory rate and blood oxygen saturation in the two groups as well as scores on mental status,com-fort,sedative effects and stress factors were recorded. Vital signs,mood swings and adverse reactions at different time points after surgery were compared between two groups. RESULTS:The vital signs at different time points in the observation group were all significantly better than in the control group,DEX intervention reduced shivering yet significantly improved comfort. Postoperative cognitive impairment was associated with internal medicine diseases,anesthesia factors and cerebral anoxia. CONCLUSIONS:DEX has positive effect on cognitive impairment in patients after transurethral resection of prostate.