实用老年医学

实用老年医学 ›› 2021, Vol. 35 ›› Issue (3): 286-289.doi: 10.3969/j.issn.1003-9198.2021.03.019

• 临床研究 • 上一篇    下一篇

丙泊酚不同输注方式对老年病人髋关节置换术后谵妄的影响

姚杰, 刘斐, 左慕妍, 陈艳林, 徐晓晴, 王丽, 滕金亮, 李福龙   

  1. 075000 河北省张家口市,河北北方学院附属第一医院麻醉科(姚杰,陈艳林,徐晓晴,王丽,滕金亮,李福龙);重症医学科(刘斐);
    067000 河北省承德市,承德医学院附属医院麻醉科(左慕妍)
  • 收稿日期:2020-04-09 发布日期:2021-04-02
  • 基金资助:
    河北省卫健委医学科研项目(20190888);张家口市科技计划项目(1921031D)

Effects of different methods infusion of propofol on delirium in elderly patients receiving hip replacement surgery

YAO Jie, CHEN Yan-lin, XU Xiao-qing, WANG Li, TENG Jin-liang, LI Fu-long, LIU Fei, ZUO Mu-yan   

  1. YAO Jie, CHEN Yan-lin, XU Xiao-qing, WANG Li, TENG Jin-liang, LI Fu-long. Department of Anesthesiology;LIU Fei. Intensive Care Unit, the First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, China;
    ZUO Mu-yan. Department of Anesthesiology, the Affiliated Hospital of Chengde Medical College,Chengde 067000,China
  • Received:2020-04-09 Published:2021-04-02

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摘要： 目的 比较丙泊酚不同输注方式对老年病人髋关节置换术后早期认知功能的影响。方法 选取2017年12月至2019年12月在河北北方学院附属第一医院骨科行髋关节置换术的老年病人60例为研究对象,将病人随机分为闭环靶控输注组(A组)和经验组(B组),每组30例。比较2组病人围术期情况,包括麻醉和手术时间、液体出入量,麻醉药物的总用量以及躁动、恶心呕吐和术中知晓等不良反应情况;比较2组病人术后疼痛、认知功能评分及术后谵妄发生率。结果 A组围术期丙泊酚、顺式阿曲库铵的总用量少于B组,差异有统计学意义 (P<0.05)。A组术后2、6 h的谵妄评定法(CAM)评分均低于B组,差异有统计学意义 (P<0.05)。A组术后谵妄发生率为17.2%,B组术后谵妄发生率为37.9%,差异无统计学意义 (P=0.078)。结论 丙泊酚闭环靶控输注可减少老年病人全身麻醉药物的用量,并显著减少病人术后早期谵妄的发生。

关键词: 输注方式, 靶控, 丙泊酚, 老年人, 谵妄

Abstract: Objective To investigate the effects of propofol infusion by different methods on delirium in the elderly patients receiving hip replacement surgery. Methods Sixty patients undergoing hip replacement with general anesthesia were assigned into dose-loop target control infusion group(group A)and experienced group(group B) by random number table with 30 cases in each group. The events in operation were recorded and compared, including anesthesia time, surgery time, fluid volume, blood loss, urine volume. The total usage of propofol, remifentanil and cisatraeurium, and the incidence rates of emergence agitation, postoperative nausea and vomiting and intraoperative awareness were also recorded and compared. The cognitive function score of patients before and after anesthesia, the incidence rate of postoperative delirium were recorded and compared between the two groups. Results The perioperative dosages of propofol and cisatraeurium in group A were significantly lower than those in group B (P<0. 05). The CAM scores in group A were significantly lower than those in group B 2, 6 hours after operation. The incidence rate of postperative delirium in group A and group B was 17. 2%, 37. 9% respectively (P=0. 078). Conclusions Closed loop target control infusion of propofol can reduce the dosage of anesthetics and the incidence rate of postoperative delirium.

Key words: methods of infusion, target controlled infusion, propofol, aged, delirium

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