文章摘要
张娜娜,孔 敏,王成东,刘昊昊,童 柱,李 斌,武静茹.右美托咪定治疗老年精神病患者无抽搐电休克的临床效果分析[J].,2020,(10):1889-1892
右美托咪定治疗老年精神病患者无抽搐电休克的临床效果分析
Analysis of the Clinical effect of Dexmedetomidine on the Elderly Mental Illness Patients Without Electroconvulsive Therapy
投稿时间:2019-09-05  修订日期:2019-09-30
DOI:10.13241/j.cnki.pmb.2020.10.020
中文关键词: 右美托咪定  老年精神病  无抽搐电休克治疗  生命体征  免疫功能
英文关键词: Dexmedetomidine  Senile psychosis  Electroconvulsive therapy without convulsion  Vital signs  Immune function
基金项目:浙江省公益技术应用研究计划项目(LGD19C090001)
作者单位E-mail
张娜娜 徐州医科大学麻醉学院 江苏 徐州 221004 15950664287@163.com 
孔 敏 嘉兴学院附属第一医院麻醉科 浙江 嘉兴 314000  
王成东 徐州市东方人民医院强制科 江苏 徐州 221004  
刘昊昊 徐州市东方人民医院电休克室 江苏 徐州 221004  
童 柱 徐州市东方人民医院精神六科 江苏 徐州 221004  
李 斌 徐州市东方人民医院老年科 江苏 徐州 221004  
武静茹 徐州医科大学麻醉学院 江苏 徐州 221004  
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中文摘要:
      摘要 目的:探讨右美托咪定治疗老年精神病患者无抽搐电休克的临床效果。方法:选择2015年9月~2019年2月在徐州医科大学(本院)进行无抽搐电休克治疗的老年精神病患者60例,根据随机数字表法将其分为右美托咪定组与对照组,每组各30例。两组都给予丙泊酚静脉注射麻醉,电休克治疗前10 min右美托咪定组缓慢推注右美托咪定0.2 ?滋g/kg(20 mL),对照组推注20 mL的生理盐水,记录和比较两组的麻醉效果与患者生命体征的波动情况。结果:右美托咪定组的丙泊酚用量、意识恢复时间与定向力恢复时间都显著低于或短于对照组(P<0.05)。两组麻醉前、无抽搐电休克治疗20 min的收缩压、舒张压、心率都处于正常范围内,组内与组间对比差异均无统计学意义(P>0.05)。两组治疗前后血清IgA、IgM值变化比较差异均无统计学意义(P>0.05)。右美托咪定组治疗期间的烦躁、惊恐发作、苏醒延迟、头痛、恶心呕吐等不良反应发生率为6.7 %,显著低于对照组(36.7 %,P<0.05)。结论:右美托咪定用于治疗老年精神病患者无抽搐电休克治疗不会对机体的生命体征与免疫功能产生负面影响,且能减少丙泊酚用量,提高麻醉效果,安全性更高。
英文摘要:
      ABSTRACT Objective: To investigate of the clinical effect of dexmedetomidine on the elderly mental illness patients without electroconvulsive therapy. Methods: 60 elderly mental illness patients who underwent with electroconvulsive therapy in our hospital from September 2015 to February 2019 were enrolled in this study. They were divided into divided into the dexmedetomidine group and control group accorded to the random number table method, 30 cases in each group. The two groups were given intravenous anesthesia with propofol, and the dexmedetomidine group was given a short bolus injection with dexmedetomidine 0.2 μg/kg (20 mL) 10 min before electroconvulsive therapy, and the control group was bolused with 20 mL of normal saline. Record and compare the anesthetic effect of the two groups and the vital signs fluctuations. Results: The amount of propofol, recovery time and recovery time of the dexmedetomidine group were significantly lower or shorter than in the control group (P<0.05). The systolic blood pressure, diastolic blood pressure and heart rate of the two groups before anesthesia and without electroconvulsive shock for 20 min were within the normal range. There was no significant difference between the two groups (P>0.05). There were no significant differences in serum IgA and IgM between the two groups before and after treatment (P>0.05). The incidence of adverse reactions such as irritability, panic attacks, delayed recovery, headache, nausea and vomiting during the dexmedetomidine group were 6.7%, which was significantly lower than of the control group (36.7%, P<0.05). Conclusion: Dexmedetomidine for the treatment of elderly mental illness patients without convulsion electroconvulsive therapy will not have a negative impact on the vital signs and immune function of the body, can reduce the amount of propofol, improve the anesthetic effect, and have higher safety.
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