不同剂量右美托咪定对老年肺癌术后早期认知功能的影响

摘要

目的:研究右美托咪定(Dex)对老年肺癌术后早期认知功能的影响及其与麻醉药物剂量的相关性.方法:择期全麻下行肺叶或全肺切除老年患者60例,随机分为对照组(C组)、低剂量Dex组(LD组)、中剂量Dex组(MD组)和高剂量Dex组(HD组)各15例.分别于麻醉诱导前(T0)、进胸时(T1)、术毕(T2)和术后1 d(T3)记录患者平均动脉压、心率(HR)和脉搏血氧饱和度;通过神经功能测验项目简易精神状态评价量表(MMSE)进行术前1 d及术后第1、3、7天对4组患者术后认知功能评分,通过躁动评分表记录麻醉后恢复室(PACU)镇静评分.结果:与T0比较,C组T1平均动脉压明显升高(P0.05).与术前1 d比较,C组术后第1天MMSE评分显著降低(P0. 05). Compared 1 d before operation,the MMSE score in group C decreased significantly 1 d after operation(P<0. 01). Compared with group C,the MMSE scores in other three groups significantly increased 1 d after operation(P<0. 01). The differences of the incidences of postoperative cognitive dysfunction between four groups were statistically significant 1 d after operation(P<0. 05). Conclusions:The application of Dex in elderly patients treated with lobectomy or pneumonectomy can maintan the hemodynamic stability,and reduce the incidence of postoperative cognitive dysfunction,which has no obvious dependence on the anesthetic drug dose.