右美托咪定对老年患者全麻术后认知功能及炎症因子的影响-论文.pdf

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1、2300实用医学杂志2014年第30卷第l4期·药物与临床·右美托咪定对老年患者全麻术后认知功能及炎症因子的影响孟海兵来伟帅君丁国友摘要目的：观察右美托咪定(DEX)对老年患者全麻术后认知功能和炎症因子的影响。方法：选择我院进行全麻手术的老年患者70例．随机分为观察组和对照组，观察组在常规全麻基础上加用DEX，对照组给予相应生理盐水，于手术前1天和手术后第1、3、5、7天进行简易智力状态测试(MMSE)，进行评分并计算术后认知功能障碍(POCD)发生率，并分别于麻醉前、切皮时、手术结束时和术后lh测定两组患者血清白

2、介素一6(IL．6)和肿瘤坏死因子(TNF．仅)水平。结果：术后1和3d，观察组MMSE评分均显著高于对照组(P

3、降低炎症反应。关键词右美托咪定：老年；认知功能；TNF．；IL．6CIinicalanalysisofefectofDexmedetomidineonpostoperativecognitivefunctionandpreoperativeinflammationintheelderlypatientsundergoinggeneralanesthesiaMENGHai—bing，，Wei，SHUAIJun，D1NGGuo—you．DepartmentofAnesthesiology，ChinesePeople’S

4、LiberationArmyNO．94Hospital，Nanchang33oo02．ChinaCorrespondingauthor：DINGGuo—youE—mail：498331866@qq．con【Abstract】ObjectiveTostudytheeffectofdexmedetomidine(DEX)onpostoperativecognitivefunctionandpreoperativeinflammationintheelderlypatientsundergoinggeneralanest

5、hesia．Methods70elderlypatientsundergoinggeneralanesthesiaoperationwerechosenanddividedintoobservationgroupandcontrolgrouprandomly．DEXandphysiologicalsalinewereappliedinobservationgrouponthebasisofroutinegenerManesthesia．Thecognitivefunctionofpatientsinbothgrou

6、psweretestedbymini—mentalstateexamination(MMSE)andtheincidencerateofcognitivedysfunction(POCD)weremeasuredat1daybeforesurgery，1day，3days，5days，and7daysaftersurgery．Thelevelofinterleukin一6(IL一6)andtumornecrosisfactor一0l(TNF—)weretestedbeforeanesthesia，duringski

7、nincision，rightlyafteroperationandlhafteroperation．ResultsMMSEscoresweresignificantlyhigherandtheincidentratesofPOCDwerelowerinobservationgroupthanthoseincontrolgroupat1dayand3daysaftersurgery(尸<0．05)．ThelevelsofIL一6andTNF—O／．increasedobviouslyduringskinincisi

8、onandpostoperativeperiod，andtheyweresignificantlylowerinobservationgroup(P<0．05)．ThelevelsofIL-6andTNF—ddecreasedtothelevelsbeforeanesthesiainobservationgroup，andwerestillmuchhighe