| 张红军,杨晋东,逯 焜,何 毅,刘 慧,佟 鑫.右美托咪定复合小剂量艾司氯胺酮对髋骨骨折老年患者术后早期认知功能和应激反应的影响[J].,2023,(23):4573-4577 |
| 右美托咪定复合小剂量艾司氯胺酮对髋骨骨折老年患者术后早期认知功能和应激反应的影响 |
| Effect of Dexmedetomidine Combined with Low-dose Esketamine on Early Postoperative Cognitive Function and Stress Response in elderly Patients with Hip Fractures |
| 投稿时间：2023-05-23 修订日期：2023-06-18 |
| DOI：10.13241/j.cnki.pmb.2023.23.035 |
| 中文关键词: 右美托咪定 髋骨骨折 艾司氯胺酮 认知功能 应激反应 |
| 英文关键词: Dexmedetomidine Hip bone fracture Esketamine Cognitive function Stress response |
| 基金项目:四川省卫生健康委员会医学科技项目（普及应用项目）（21PJ147） |
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| 中文摘要: |
| 摘要 目的：探讨右美托咪定复合小剂量艾司氯胺酮对髋骨折老年患者术后早期认知功能和应激反应的影响。方法：选取110例髋骨骨折老年患者，按照随机数字表法分为观察组（采用右美托咪定复合小剂量艾司氯胺酮麻醉）55例与对照组（采用右美托咪定麻醉）55例。观察两组的血流动力学、疼痛程度、应激反应、认知功能以及不良反应。结果：在T1、T2、T3、T4点，观察组患者的舒张压（diastolic blood pressure，DBP）、收缩压（systolic blood pressure，SBP）、心率（heart rate，HR）均低于对照患者（P<0.05）。观察组术后6 h、12 h、24 h疼痛评分均显著低于对照组（P<0.05）。麻醉前，两组患者的应激反应比较无统计学意义（P>0.05）；术后6 h，观察组去甲肾上腺素、促肾上腺皮质激素和皮质醇低于对照组患者（P＜0.05）。观察组术后1 d认知功能评分高于对照组（P<0.05）。两组恶心、呕吐、低血压、头痛等不良反应发生率比较无统计学意义（P>0.05）。结论：右美托咪定复合小剂量艾司氯胺酮能够提高髋骨骨折老年患者术后早期认知功能，维持稳定血流动力学，减轻疼痛感，改善应激反应，安全性较高。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of dexmedetomidine combined with low-dose Esketamine on early postoperative cognitive function and stress response in elderly patients with hip fractures. Methods: 110 elderly patients with hip fractures were selected. They were randomly divided into an observation group (using dexmedetomidine combined with low-dose Esketamine anesthesia) with 55 patients and a control group (using dexmedetomidine anesthesia) with 55 patients. Observe the hemodynamics, degree of pain, stress response, cognitive function, and adverse reactions of the two groups. Results: At points T1, T2, T3, and T4, the diastolic blood pressure (DBP), systolic blood pressure (SBP), and heart rate (HR) of the observation group were lower (P<0.05). The pain scores at 6 h, 12 h, and 24 h after surgery in the observation group were significantly lower (P<0.05). Before anesthesia, there was no difference in stress response between the two groups of patients (P>0.05). At 6 hours after surgery, the levels of norepinephrine, adrenocorticotropic hormone, and cortisol in the observation group were lower (P<0.05). The cognitive function score of the observation group on the first day after surgery was higher (P<0.05). There was no difference in the incidence of adverse reactions such as nausea, vomiting, hypotension, and headache between the two groups (P>0.05). Conclusion: The combination of dexmedetomidine and low-dose Esketamine can improve early postoperative cognitive function, maintain stable hemodynamics, reduce pain, improve stress response, and have high safety in elderly patients with hip fracture. |
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