右美托咪定对老年颈椎手术患者术后认知功能的影响

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Abstract Objective To investigate the effects of Dexmedetomidine on cognitive function in elderly patients after cervical spine surgery. Methods From December 2016 to May 2017, 50 cases of elderly patients with receive cervical spine surgery in Shandong Provincial Hospital were selected, and divided into Dexmedetomidine group (DEX group) and control group (C group) by random number table, each group with 25 cases. The DEX group was treated with intravenous drip Dexmedetomidine at the beginning of the operation, and the C group was treated the same dose of saline. The mini-mental state examination (MMSE) was scored performed in both groups before and after surgery 3, 5, 10, 20 d and 40 d, and the cognitive function of the patient was evaluated. The postoperative cognitive dysfunction (POCD) incidence rate of the two groups was compared, and the mean arterial blood pressure (MAP), heart rate, operation time, blood loss and the use of narcotic drugs between groups were compared during surgery. Results There was no significant difference between the two groups in the aspect of the MAP, heart rate, operation time, blood loss during surgery (P > 0.05). The dosage of Remifentanil, Fentanyl and Propofol in the DEX group were all lower than those of C group during surgery, the differences were statistically significant (P < 0.05), while there was no significant difference the two groups of the dosage of Vecuronium (P > 0.05). The MMSE score of after surgery 3 d and 5 d in C group was lower than that before surgery, the difference was statistically significant (P < 0.05), however, the MMSE scores after surgery 3, 5, 10, 20 d and 40 d in the DEX group were compared with those before surgery, the difference was not statistically significant (P > 0.05). The MMSE score of after surgery 3 d and 5 d in the DEX group was higher than C group, the difference was statistically significant (P < 0.05). The incidence of POCD after operation in DEX group was 8%, and the C group was 24%, the two groups were compared, the difference was statistically significant (P < 0.05). Conclusion Dexmedetomidine can be effectively prevent the occurrence of cognitive dysfunction in elderly patients after cervical spine surgery, and it reduces the clinical dosages of Remifentanil, Fentanyl and Propofol to a certain extent.

Key words： Dexmedetomidine Elderly patients Postoperative cognitive function MMSE score

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	WE Yuqin WANG Hong CHEN Qunsheng WANG Gongming

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WE Yuqin WANG Hong CHEN Qunsheng WANG Gongming. Effects of Dexmedetomidine on cognitive function in elderly patients after cervical spine surgery[J]. 中国医药导报, 2018, 15(12): 58-60,77.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2018/V15/I12/58

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