右美托咪定对胸腰椎体骨折患者的影响

Effect of Dexmedetomidine on thoracolumbar vertebral body fractures

摘要:

目的 探讨右美托咪定复合舒芬太尼对胸腰椎体骨折患者手术后认知状况的影响。方法 选取2015 年5 月-2016 年3 月贵州医科大学附属医院收治的胸腰椎体骨折患者92 例，依据随机数表法分为观察组（右美托咪定+ 舒芬太尼）和对照组（舒芬太尼），比较两组手术情况、简易智力状态检查量表（MMSE）评分和神经功能。结果 两组患者的手术时间、麻醉时间、清醒时间及拔管时间无差异（P >0.05）。观察组比对照组MMSE 评分高，认知功能好。观察组与对照组相比斯特鲁普效应实验完成时间较低，韦氏智力量表评分、数字符号替换实验正确数较高，神经功能较好。结论 右美托咪定复合舒芬太尼能够有效避免胸腰椎体骨折患者手术后认知障碍，改善患者神经功能，且不延长术后苏醒时间，值得临床推广。

Abstract:

Objective To investigate the effect of Dexmedetomidine combined with Sufentanil on cognition in patients with thoracolumbar vertebral fractures after surgery. Methods Ninety-two patients with thoracolumber vertebral fractures treated in our hospital from May 2015 to March 2016 were selected, and divided into observation group (Dexmedetomidine+Sufentanil) and control group (Sufentanil) according to a random number table method. The operative situation, Mini-mental State Examination Scale (MMSE) score and nerve function were compared. Results There was no significant difference in the operation time, anesthesia time, awakening time or extubation time between the two groups (P > 0.05). Compared with the control group, the MMSE score of the observation group was higher, and the cognitive function was better in the observation group. Compared with the control group, the completion time of the Stroop effect was shorter, the WAIS Intelligence Scale score was lower, the correct number of DSST number symbol substitution test was higher, the nerve function was better in the observation group. Conclusions Dexmedetomidine combined with Sufentanil can effectively prevent cognitive impairment in patients with thoracolumbar vertebral fractures, and improve neurological function, but would not prolong the postoperative awakening time. It is worthy of clinical popularization.