右美托咪定对老年患者术后认知功能的影响

摘要

Objective To study the effects of dexmedetomidine on the occurrence of postoperative cognitive dysfunction(POCD) in the elderly .Methods Sixty elderly patients undergoing radical resection of esophageal carcinoma were equally and randomly assigned into two groups .The patients in group A were infused with dexmedetomidine 1 μg/kg in 10 minutes before anesthesia induction ,which was follwed by pumping dexmedetomidine 0.5μg/h till 30 minutes before the end of surgery .Group B was not given dexmedetomidine as the control .Mini‐mental state examination (MMSE) scoring was performed day before and at 24 hours after operation .The expressions of IL‐1βand IL‐6 in peripheral blood were detected .Results The incidence of POCD on the 1st postoperative day was lower in group A than that in group B(26.7% vs .56.7% )(P<0 .01) .The expressions of IL‐1βand IL‐6 in group B were higher after operation than those before and in group A(P<0 .05) . The expression of IL‐6 in group A was higher after operation than that before(P<0 .05) .Conclusion Dexmedetomidine can reduce the incidence of POCD in the elderly .%目的：探讨右美托咪定对老年患者术后认知功能的影响。方法择期行食管癌根治术的老年患者60例随机均分为两组：A组麻醉前10 min内泵入右美托咪定1μg／kg ，继以0.5μg／h泵入，手术结束前30 min停药；B组不用右美托咪定作为对照。分别于术前和术后1 d行简易智能状态量表（MMSE）评分，检测术前及术后1、6 h外周血IL‐1β和IL‐6。结果术后1 d ，A组的术后认知功能障碍（POCD）发生率低于B组（26.7％ vs ．56.7％）（P＜0．01）。A组患者术后仅IL‐6水平较术前升高（ P＜0．05）；B组术后IL‐1β和IL‐6水平均较术前升高，且高于A组（ P＜0．05）。结论右美托咪定可降低老年患者POCD的发生。