目的 观察右美托咪定对老年患者全髋关节置换术后早期认知功能的影响.方法 择期行全髋关节置换术患者60例,年龄65～80岁,随机均分为两组,术中分别持续泵注右美托咪定(D组)或等量生理盐水(N组).两组均采用腰-硬联合麻醉.分别于术前1天和术后第7天对患者进行神经精神功能测试.结果 术后第7天D组术后认知功能障碍(POCD)发生率明显低于N组(20％ vs.50％,P＜0.05).结论 右美托咪定可能降低老年患者全髋关节置换术后POCD的发生率.%Objective To determine the influence of dexmedetomidine on postoperative cognitive dysfunction (POCD) in the elderly patients undergoing total hip replacement surgery. Methods Sixty elderly patients aged 65-80 years, undergoing elective total hip replacement surgery by combined spinal-epidural anesthesia were randomly allocated to receive either intravenous dexmedetomidine( group D, 30 cases) or the same volume of normal saline instead (group N, 30 cases). Cognitive function was assessed preoperatively and on the 7th postoperative day using a battery of nine neuropsychological tests. Results On the 7th postoperative day, the incidence of POCD in group D (20.0%) was significantly lower than that in group N(50.0%) (P<0.05). Conclusion Dexmedetomidin infusion could effectively decrease the incidence of early POCD in elderly patients undergoing total hip replacement surgery
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