在线办公
期刊论坛
主 管
中国人民解放军总医院
主 办
中国人民解放军总医院老年心血管病研究所
中国科技出版传媒股份有限公司
编 辑
中华老年多器官疾病杂志编辑委员会
100853, 北京市复兴路28号
电话:010-66936756
传真:010-66936756
E-mail: zhlndqg@mode301.cn
创刊人 王士雯
总编辑 范利
副总编辑 陈韵岱
执行主编 叶大训
编辑部主任 王雪萍
ISSN 1671-5403
CN 11-4786
创刊时间 2002年
出版周期 月刊
邮发代号 82-408
友情链接
曹惠鹃,赵红,周锦,周南,张铁铮.不同剂量右美托咪定对老年患者内镜逆行胰胆管造影术后认知功能的影响[J].中华老年多器官疾病杂志,2019,18(5):341~345
不同剂量右美托咪定对老年患者内镜逆行胰胆管造影术后认知功能的影响
Effects of different doses of dexmedetomidine on postoperative cognitive function in elderly after endoscopic retrograde cholangiopancreatography
投稿时间:2018-11-25  
DOI:10.11915/j.issn.1671-5403.2019.05.070
中文关键词:  老年人;内镜逆行胰胆管造影术;右美托咪定;认知功能障碍
英文关键词:aged; endoscopic retrograde cholangiopancreatography; dexmedetomidine; cognitive dysfunction This work was supported by the Tackling Project of Scientific and Technological Research of Liaoning Province
基金项目:辽宁省科技攻关项目(2013225220)
作者单位E-mail
曹惠鹃 北部战区总医院麻醉科,沈阳 110016 caohuijuan1212@sina.com 
赵红 沈阳市第四人民医院麻醉科,沈阳 110031  
周锦 北部战区总医院麻醉科,沈阳 110016  
周南 北部战区总医院麻醉科,沈阳 110016  
张铁铮 北部战区总医院麻醉科,沈阳 110016  
摘要点击次数: 185
全文下载次数: 197
中文摘要:
      目的 观察不同剂量右美托咪定对老年患者行内镜逆行胰胆管造影(ERCP)术后认知功能的影响。方法 入选2014年5月至2015年1月北部战区总医院麻醉科择期行ERCP的老年患者(≥65岁)120例,随机数表法将患者分为对照组(C组)、0.5μg右美托咪定组(D1组)和0.8μg右美托咪定组(D2组),每组40例。右美托咪定组均于麻醉诱导前给予右美托咪定1.0μg/kg的负荷量,输注时间10min,然后分别持续输注0.5μg/(kg·h)和0.8μg/(kg·h)至手术结束,C组输注等容积的生理盐水。记录患者一般情况、术中用药量、不良反应发生率,并分别于术前(Ta)、术毕即刻(Tb)、术后24h(Tc)采集患者静脉血,用ELISA法检测血浆中白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及S-100β蛋白水平。于术前第1天、术后第1天和第3天用成人简易智能精神状态检查(MMSE)量表评估患者是否发生认知功能障碍(POCD)。采用SPSS 19.0统计软件对数据进行分析。组间比较采用方差分析或χ2检验。结果 与C组比较,D1组和D2组患者丙泊酚用量[(112.84±40.10) vs(182.01±61.88)mg;(100.96±46.64) vs(182.01±61.88)mg]减少,差异均有统计学意义(P<0.05);D1组和D2组患者Tb和Tc时IL-6、TNF-α和S-100β蛋白水平均降低,且差异均有统计学意义(P<0.05)。3组患者体动、呃逆及呼吸抑制发生率差异均有统计学意义(P<0.05)。D1和D2组患者术后各1例发生POCD,发生率均为2.5%(1/40),C组患者术后共8例发生POCD,发生率为20.0%(8/40),差异有统计学意义(P=0.005)。结论 老年人ERCP术中应用右美托咪定可减少丙泊酚用量和不良反应,降低POCD的发生率。
英文摘要:
      Objective To investigate the effect of different doses of dexmedetomidine on cognitive function in elderly patients after endoscopic retrograde cholangiopancreatography (ERCP). Methods A total of 120 elderly patients (≥65 years old) undergoing elective ERCP in the General Hospital of Northern Theater Command from May 2014 to January 2015 were recruited in this study. They were randomly divided into control group (group C), 0.5 μg(group D1) and 0.8 μg dexmedetomidine group (group D2), with 40 cases in each group. Dexmedetomidine of 1.0 μg/kg were infused before induction to the patients of the latter 2 groups as loading dose for 10 min, and then were given at 0.5 μg/(kg·h) (group D1) or 0.8 μg/(kg·h) (group D2) by continued infusion until the end of surgery. The group C was infused with the same volume of normal saline. The clinical data, such as general condition, intraoperative dosage of propofol, and incidences of adverse reactions were recorded. Venous blood samples were collected to detect the levels of tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6) and soluble protein 100-β (S-100β) by ELISA before operation (Ta), immediately after operation (Tb), and 24 h after operation (Tc). Mini-mental state examination (MMSE) was perfermed to test the occurrence of postoperative cognitive dysfunction (POCD) at 1 d before, 1 d and 3 d after operation. The data was analyzed by using SPSS statistics 19.0. Comparison among groups was performed by analysis of variance or Chi-square test. Results Compared with group C [(182.01±61.88)mg], the dosage of propofol was significantly lower in group D1 [(112.84±40.10)mg] and group D2 [(100.96±46.64)mg], both with significant difference (P<0.05). The plasma levels of TNF-α, IL-6 and S-100β were also obviously lower in group D1 and group D2 at Tb and Tc when compared with group C (all P<0.05). Statistical differences were seen in the incidences of body movement, hiccups and respiratory depression among the 3 groups (P<0.05). After operation there was 1 patient suffering from POCD in group D1, with the incidence rate of 2.5%, so was in group D2, and the rate was significantly lower than that of group C (8 cases, 20.0%, P=0.005). Conclusion Intraoperative infusion of dexmedetomidine can reduce the dosage of propofol and prevent adverse reactions in the elderly undergoing ERCP, and decrease the occurrence of POCD at the same time.
查看全文    下载PDF阅读器
关闭