右美托咪定联合瑞芬太尼对老年骨科 手术患者围手术期影响
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高亮,女,主治医师,主要研究方向是麻醉。

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R 614

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Effects of Dexmedetomidine Combined with Remifentanil on Perioperative Period of Elderly Patients Undergoing Orthopedic Surgery
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    摘要:

    摘 要目的:研究右美托咪定联合瑞芬太尼对老年骨科手术患者围手术期的影响。 方法:选取 2018 年 4 月至 2021 年 3 月周口市中医院行骨科手术的 110 例老年患者,随机分为观察组和对照组,各 55 例。对照组患者采用丙泊酚联合瑞芬太 尼麻醉,观察组患者采用右美托咪定联合瑞芬太尼麻醉。观察比较两组患者围手术期心率(HR)、平均动脉压(MAP)、 呼吸频率(RR)、动脉血氧饱和度(SpO2)、苏醒质量及认知功能的变化。 结果:麻醉用药后 30 min(T3)、清醒后(T4) 时,观察组患者 HR、MAP 高于对照组,差异具有统计学意义(P < 0.05)。麻醉用药后 10 min(T2)、T3 时,观察组患 者 RR、SpO2 高于对照组,差异具有统计学意义(P < 0.05)。术后 20 min 和术后 30 min,观察组患者 Ramsay 镇静量表(RSS) 评分低于对照组,差异具有统计学意义(P < 0.05)。两组患者蒙特利尔认知评估量表(MoCA)评分比较,差异无统计学 意义(P > 0.05)。 结论:右美托咪定联合瑞芬太尼在行老年骨科手术患者的治疗过程中可改善围手术期呼吸、血流动力学, 患者苏醒质量良好,并且对认知功能并未产生较大的影响。

    Abstract:

    AbstractObjective To study the effects of dexmedetomidine combined with remifentanil on perioperative period of elderly patients undergoing orthopedic surgery. Methods 110 elderly patients who underwent orthopedic surgery in Zhoukou Hospital of Traditional Chinese Medicine (TCM) from April 2018 to March 2021 were selected and randomly divided into an observation group and a control group, with 55 cases in each group. The control group was anesthetized with propofol and remifentanil, and the observation group was anesthetized with dexmedetomidine and remifentanil. The changes in perioperative heart rate (HR), mean arterial pressure (MAP), respiratory rate (RR), arterial oxygen saturation (SpO2), recovery quality and cognitive function were observed and compared between both groups of patients. Results At 30 min after anesthesia (T3) and after waking up (T4), the HR and MAP in the observation group were higher than those of the control group (P < 0.05). The RR and SpO2 in the observation group at 10 min after anesthesia (T2) and at T3 were higher than those of the control group (P < 0.05). Ramsay Sedation Scale (RSS) score in the observation group was lower than that of the control group at 20 min and 30 min after surgery (P < 0.05). There was no statistical significance in the score of Montreal Cognitive Assessment Scale (MoCA) between the two groups (P > 0.05). Conclusion Dexmedetomidine combined with remifentanil can improve the perioperative respiration and hemodynamics in the treatment process of elderly patients undergoing orthopedic surgery, and it has good recovery quality and has no significant impact on cognitive function.

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  • 收稿日期:2023-03-04
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  • 在线发布日期: 2023-08-08
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