文章摘要
右美托咪定复合地佐辛静脉镇痛对老年腹腔镜胆囊切除术后患者认知功能、氧化应激及炎性因子的影响*
Effects of dexmedetomidine combined with dezocine on cognitive function, oxidative stress and inflammatory factors in elderly patients after laparoscopic cholecystectomy*
投稿时间:2021-04-04  修订日期:2021-04-04
DOI:
中文关键词: 右美托咪定  地佐辛  老年  腹腔镜胆囊切除术  认知功能  氧化应激  炎性因子
英文关键词: Dexmedetomidine  dezocine  Elderly  Laparoscopic cholecystectomy  Cognitive function  Oxidative stress  Inflammatory factors
基金项目:新疆维吾尔自治区自然科学基金资助项目(2016D01C300)
作者单位E-mail
韩静霏 新疆医科大学第一附属医院 ahjf2345@163.com 
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中文摘要:
      目的:探讨右美托咪定复合地佐辛静脉镇痛对老年腹腔镜胆囊切除术后患者认知功能、氧化应激及炎性因子的影响。方法:前瞻性选择2017年4月至2019年12月于我院拟行腹腔镜胆囊切除术的老年患者103例,采用随机数字表法将患者分为A、B两组。A组51例,给予舒芬太尼镇痛,B组52例,给予右美托咪定复合地佐辛静脉镇痛。对比两组不良反应,镇静、镇痛效果、认知功能、氧化应激及炎性因子。结果:B组术后12h、24h、48h视觉模拟评分法(VAS)评分低于A组(P<0.05),B组术后12h、24h、48h Ramsay 镇静评分高于A组(P<0.05)。B组术后1d、术后3d、术后5d简易智能量表(MMSE)评分均高于A组(P<0.05),B组认知功能障碍(POCD)发生率低于A组(P<0.05)。B组术后3d、术后5d丙二醛(MDA)低于A组,总抗氧化能力(T-AOC)、超氧化物歧化酶(SOD)高于A组(P<0.05)。B组术后3d、术后5d白介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)低于A组(P<0.05)。对比两组不良反应无差异(P>0.05)。结论:与舒芬太尼相比,在地佐辛静脉镇痛基础上,加以右美托咪定,可在腹腔镜胆囊切除术后老年患者中取得较好镇痛镇静效果,可减轻其认知功能损害、氧化应激及炎性反应,且安全可靠。
英文摘要:
      Objective: To investigate the effects of dexmedetomidine combined with dezocine on cognitive function, oxidative stress and inflammatory factors in elderly patients after laparoscopic cholecystectomy. Methods: 103 elderly patients who were planned to undergo laparoscopic cholecystectomy and admitted in our hospital from April 2017 to December 2019 were prospectively selected, patients were divided into group A, B by random number table method. 51 cases in group A, given sufentanil for analgesia, 52 cases in group B, given dexmedetomidine combined with dezocine intravenous analgesia. The adverse reactions, sedation, analgesic effect, cognitive function, oxidative stress and inflammatory factors were compared between the two groups. Results: The visual analogue scale(VAS)scores of group B were lower than those of group A at 12h, 24h, 48h after operation (P < 0.05), Ramsay sedation scores of group B were higher than those of group A at 12h, 24h and 48h after operation (P < 0.05). The scores of mini-mental state examination(MMSE)at 1d after operation, 3d after operation, 5d after operation in group B were higher than those of group A (P < 0.05), the incidence of postoperative cognitive dysfunction (POCD) in group B was lower than that of group A (P < 0.05). Malondialdehyde (MDA) at 3d after operation, 5d after operation in group B were lower than those of group A, the total antioxidant capacity (T-AOC), superoxide dismutase (SOD) in group B were higher than those of group A (P < 0.05). The levels of interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs CRP), tumor necrosis factor - α (TNF - α) at 3d after operation, 5d after operation in group B were lower than those of group A (P < 0.05). There was no difference in adverse reactions between the two groups (P > 0.05). Conclusion: Compared with sufentanil, on the basis of dezocine intravenous analgesia, combined with dexmedetomidine, can obtain better analgesic and sedative effect in elderly patients with laparoscopic cholecystectomy, which can reduce cognitive impairment, oxidative stress and inflammatory reaction, and is safe and reliable.
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