实用老年医学

实用老年医学 ›› 2026, Vol. 40 ›› Issue (8): 821-825.doi: 10.3969/j.issn.1003-9198.2026.08.013

• 临床研究 • 上一篇    下一篇

α2肾上腺素受体激动剂对老年白内障超声乳化手术患者的影响研究

方响响, 杨庆松, 鞠学军, 姜巧妹, 鲍红光, LI JIANG, 丁振琴   

  1. 211102 江苏省南京市,东南大学医学院附属南京同仁医院麻醉科(方响响,鞠学军,姜巧妹);眼科(杨庆松);
    210006 江苏省南京市,南京医科大学附属南京医院麻醉科(鲍红光);科教科(丁振琴);
    B15 2WB Birmingham,Queen Elizabeth Medical Hospital, United Kingdom(LI JIANG)
  • 收稿日期:2026-01-26 出版日期:2026-08-20 发布日期:2026-08-24
  • 通讯作者: 杨庆松,Email:Yangqs@njtrh.org
  • 基金资助:
    南京市国际/港澳台科技合作计划项目(202401044)

Effects of α2-adrenergic receptor agonist on elderly patients undergoing cataract phacoemulsification surgery

FANG Xiangxiang, YANG Qingsong, JU Xuejun, JIANG Qiaomei, BAO Hongguang, LI Jiang, DING Zhenqin   

  1. Department of Anesthesiology (FANG Xiangxiang, JU Xuejun, JIANG Qiaomei); Department of Ophthalmology(YANG Qingsong), Nanjing Tongren Hospital Affiliated to the Southeast University School of Medicine, Nanjing 211102, China;
    Department of Anesthesiology (BAO Hongguang); Department of Science and Education (DING Zhenqin), Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing 210006,China;
    Queen Elizabeth Medical Hospital, Birmingham B15 2WB, United Kingdom(LI Jiang)
  • Received:2026-01-26 Online:2026-08-20 Published:2026-08-24
  • Contact: YANG Qingsong, Email:Yangqs@njtrh.org

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摘要： 目的 观察α2肾上腺素受体激动剂右美托咪定对老年白内障超声乳化手术患者手术各时间点血流动力学和血糖水平、术后早期认知功能及不良反应的影响。 方法 纳入南京同仁医院择期行白内障超声乳化手术的患者96例,采用计算机生成区组随机序列,将受试者按1∶1比例分配至右美托咪定组(D组)和生理盐水对照组(C组),每组48例。2组术前均接受标准散瞳及局部麻醉方案。D组予以右美托咪定持续静脉泵注至术毕(总剂量0.5 μg/kg);C组接受等量0.9%氯化钠溶液输注。记录2组患者术前1 d及术后1、3、7 d的MMSE评分。比较2组患者术中不同时间点血流动力学及血糖水平变化,患者及手术医师满意度及不良反应发生情况。 结果 术后D组1、3、7 d的MMSE评分均高于C组(P<0.05);D组围术期血流动力学较C组更平稳、血糖波动更小,手术医师及患者满意度更高(均P<0.05);2组术后疼痛等不良反应发生率差异无统计学意义(P＞0.05)。 结论 右美托咪定可改善老年白内障超声乳化手术患者术后早期认知功能,提高患者舒适度,稳定围手术期血流动力学,减少血糖波动。

关键词: α2肾上腺素受体激动剂, 白内障超声乳化手术, 术后认知功能, 围术期血糖波动, 血流动力学

Abstract: Objective To investigate the effects of the α2-adrenergic receptor agonist dexmedetomidine on hemodynamics, blood glucose levels, early postoperative cognitive function, and adverse reactions at various time points in elderly patients undergoing phacoemulsification for cataract surgery. Methods A total of 96 patients were enrolled for elective phacoemulsification surgery at Nanjing Tongren Hospital. Using a computer-generated block randomization sequence, the subjects were allocated in a 1∶1 ratio to either the dexmedetomidine group (Group D) or the normal saline control group (Group C), with 48 cases in each group. Both groups underwent standard mydriasis and local anesthesia prior to surgery. Group D received continuous intravenous infusion of dexmedetomidine via a pump until the end of surgery (total dose: 0.5 μg/kg); Group C received an equivalent volume of 0.9% sodium chloride solution. Mini-Mental State Examination (MMSE) scores of both groups were recorded 1 d before surgery, as well as 1, 3, 7 d after operation. The changes in hemodynamic parameters and blood glucose levels at different intraoperative time points were compared between the two groups, as well as patient’s and surgeon’s satisfaction rates and incidence of adverse reactions. Results Compared with Group C, Group D exhibited higher MMSE score at each postoperative time point, more stable intraoperative hemodynamics, smaller fluctuations in blood glucose, and significantly increased satisfaction rates among surgeons and patients (P<0.05). There was no statistically significant difference in the incidence of postoperative adverse reactions between the two groups (P>0.05). Conclusions Dexmedetomidine can improve early postoperative cognitive function in elderly patients undergoing cataract phacoemulsification, enhance patient comfort, and stabilize perioperative hemodynamics and blood glucose variations.

Key words: α2-adrenergic receptor agonist, cataract phacoemulsification, postoperative cognitive function, perioperative blood glucose fluctuations, hemodynamics

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