| 摘要: |
| ［摘要］ 目的 观察右美托咪定复合氯胺酮麻醉对老年烧伤患者术后认知功能的影响。方法 选择年龄≥65岁的老年烧伤患者60例，随机分为氯胺酮组（K组）和右美托咪定复合氯胺酮组（DK组）各30例，采用简易精神状态量表（MMSE）评分方法，观察两组分别应用氯胺酮麻醉和右美托咪定复合氯胺酮麻醉术前1 d、术后1 d、3 d及7 d对老年烧伤患者认知功能的影响，并进行比较分析。结果 与术前1 d比较，两组患者术后1 d、3 d及7 d MMSE评分均下降（P<0.05），但DK组下降的幅度小于K组（P<0.05）。K组与DK组术后认知功能障碍（POCD）发生率分别为26.7%和23.3%，两组比较差异无统计学意义（P>0.05）。结论 右美托咪定复合氯胺酮麻醉可改善氯胺酮引起的老年烧伤患者POCD，但不能降低氯胺酮引起的POCD发生率。 |
| 关键词: 右美托咪定 氯胺酮 老年患者 烧伤 术后认知功能障碍 简易精神状态量表 |
| DOI：10.3969/j.issn.1674-3806.2015.04.09 |
| 分类号:R 971+.2 |
| 基金项目: |
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| Effects of dexmedetomidine combined with ketamine on postoperative cognitive dysfunction in elderly patients with burns |
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HU Zhi-chao, KONG Li, XU Peng-cheng, et al.
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Department of Anesthesiology, Fist People′s Hospital of Shangqiu City, Henan 476100, China
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| Abstract: |
| ［Abstract］ Objective To study the effects of dexmedetomidine combined with ketamine on postoperative cognitive dysfunction in elderly patients with burns.Methods Sixty cases of the elderly patients with burns were administered anesthetic ketamine(group K, n=30) and the other cases were administered anesthetic dexmedetomidine combinedation with ketamine(group DK, n=30). The postoperative cognitive dysfunctions in the groups were observed respectively on the first, the third and the seventh day after operation.Results Scores of MMSE in the two groups were both decreased compared with pre-operation(P<0.05). On the third and seventh day the scores in the two groups were increased than those on the first day in some extent, but they were both significantly lower than those before operation（P<0.05）. The score of group K was significantly decreased compared with group DK（P<0.05）. The percentages of POCD in both group K and group DK had no significant difference（P>0.05）.Conclusion Dexmedetomidine combined with ketamine in anesthesia improves postoperative cognitive dysfunction in elderly patients with burns compared with using ketamine alone. It has no effect on the occurrence of POCD. |
| Key words: Dexmedetomidine Ketamine Elderly patients Burn Postoperative cognitive dysfunction(POCD) Mini-mental state examination(MMSE) |
