| 宋 歌,王 兵,李 龙,王 平,刘乃和.右美托咪定对腰麻下老年髋关节置换术患者应激反应、肾脏功能及睡眠质量的影响[J].,2023,(19):3772-3776 |
| 右美托咪定对腰麻下老年髋关节置换术患者应激反应、肾脏功能及睡眠质量的影响 |
| Effect of Dexmedetomidine on Stress Response, Renal Function, and Sleep Quality in Elderly Patients with Total Hip Arthroplasty Under Lumbar Anesthesia |
| 投稿时间：2023-03-18 修订日期：2023-04-14 |
| DOI：10.13241/j.cnki.pmb.2023.19.035 |
| 中文关键词: 右美托咪定 老年 髋关节置换术 应激反应 肾脏功能 睡眠质量 |
| 英文关键词: Dexmedetomidine Elderly Total hip arthroplasty Stress response Renal function Sleep quality |
| 基金项目:江苏省社会发展面上基金项目（BE20210610） |
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| 中文摘要: |
| 摘要 目的：观察右美托咪定对腰麻下老年髋关节置换术（THA）患者应激反应、肾脏功能及睡眠质量的影响。方法：选择2019年10月到2022年10月期间徐州医科大学附属连云港医院收治的84例拟择期在腰麻下行THA的老年患者，按照随机数字表法将其分为对照组（常规腰麻，n=42）和观察组（常规腰麻联合右美托咪定，n=42）。观察两组镇静、镇痛评分、应激反应、肾脏功能、睡眠质量、谵妄发生率和不良反应发生率。结果：观察组术后12 h、术后1 d Ramsay镇静评分高于对照组，视觉模拟疼痛量表（VAS）评分低于对照组（P<0.05）。观察组术后1 d、术后7 d匹兹堡睡眠质量指数（PSQI）评分低于对照组（P<0.05）。观察组术后1 d皮质醇（Cor）、肾上腺素（E）、去甲肾上腺素（NE）低于对照组（P<0.05）。观察组术后1 d肌酐（Cr）、血尿素氮（BUN）、中性粒细胞明胶酶相关脂质运载蛋白（NGAL）低于对照组（P<0.05）。两组的围术期不良反应发生率对比无差异（P>0.05）。观察组的术后谵妄发生率低于对照组（P<0.05）。结论：右美托咪定用于腰麻下老年THA患者，可减轻应激反应，减轻肾脏功能损伤，降低对人体睡眠质量的影响，减少谵妄的发生率，有较好的麻醉效果。 |
| 英文摘要: |
| ABSTRACT Objective: To observe the effect of dexmedetomidine on stress response, renal function, and sleep quality in elderly patients with total hip arthroplasty (THA) under lumbar anesthesia. Methods: 84 elderly patients who were admitted to Lianyungang Hospital Affiliated to Xuzhou Medical University from October 2019 to October 2022 and planned to undergo THA under lumbar anesthesia were selected, and they were divided into control group (conventional lumbar anesthesia, n=42) and observation group (conventional lumbar anesthesia combined with dexmedetomidine, n=42) according to the random number table method. The sedation and analgesic scores, incidence of delirium, stress response, renal function, sleep quality, and incidence of adverse reactions were observed between two groups. Results: The Ramsay sedation score in observation group was higher than that in control group 12 h after surgery and 1d after surgery, and the visual analogue pain scale (VAS) score was lower than that in control group (P<0.05). The Pittsburgh sleep quality index (PSQI) score in observation group was lower than that in control group 1d after surgery and 7 d after surgery (P<0.05). The cortisol (Cor), ephrine (E), and norepinephrine (NE) in observation group were lower than those in control group 1 d after surgery (P<0.05). The creatinine (Cr), blood urea nitrogen (BUN) and neutrophil gelatinase-associated lipocalin (NGAL) in observation group were lower than those in control group 1 d after surgery(P<0.05). There was no difference in the incidence of perioperative adverse reactions between two groups (P>0.05). The incidence of postoperative delirium in observation group was lower than that in control group(P<0.05). Conclusion: Dexmedetomidine is used in elderly patients with THA under lumbar anesthesia, which can reduce stress response, reduce renal function damage, reduce the impact on human sleep quality, reduce the incidence of delirium, has good anesthesia effect. |
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