使用地氟醚联合右美托咪定抑制全身麻醉下老年患者术后神经认知障碍的可行性研究:透视研究

Ibrain Pub Date : 2022-11-23 DOI:10.1002/ibra.12073
Yue Hu, Yong Ye, Hui Lin, Jun-Jie Chen, Ting-Ting Sun, Gong-Wei Zhang, Na Wang, Yuan-Hang Shu, Xue Gong, Fei-Fei Ran, Jia-Li Zhang, Yong Tao
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摘要

本研究旨在探讨联合应用地氟醚和右美托咪定(Dex)是否能减少患者术后神经认知障碍(PND)的发生。我们选取了本院在全身麻醉下接受手术的患者,并将其分为两组:德司+地氟醚组(Dex + Des)和地氟醚组(Des)。收集患者的数据,并使用迷你精神状态检查(MMSE)评分来评估认知状况。术前和术后第 1、3 和 6 天测定血细胞计数,并记录中性粒细胞和淋巴细胞的百分比。统计方法采用独立样本 t 检验和 χ2 检验。Pearson 相关性用于分析 PND 与炎症之间的相关性。Dex+Des组的PND发生率低于Des组。Dex + Des组的术后MMSE评分高于Des组(P = 0.032)。术后第一天和第三天,Dex + Des 组的中性粒细胞百分比明显低于 Des 组(p = 0.007;p = 0.028)。术后第一天的 MMSE 评分与白细胞计数和中性粒细胞百分比的多重变化呈负相关(r = -0.3038 和 -0.3330)。Dex 联合 Des 可降低 PND 的发生率,并减少术后炎性细胞计数。
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Feasibility study of use of desflurane combined with dexmedetomidine in inhibiting postoperative neurocognitive disorders in elderly patients under general anesthesia: A perspective study

This study aimed to explore whether the combined application of desflurane and dexmedetomidine (Dex) reduces the occurrence of postoperative neurocognitive disorders (PND) in patients. We selected patients in our hospital who underwent surgery under general anesthesia, and divided them into two groups: Dex and desflurane (Dex + Des) and desflurane (Des) groups. The data of patients were collected and the Mini-Mental State Examination (MMSE) score was used to assess cognitive status. The blood cell counts were determined preoperatively and on postoperative days 1, 3, and 6, and the percentage of neutrophils and lymphocytes were also recorded. The statistical methods used were the independent-samples t-test and the χ2 test. Pearson's correlation was used to analyze the correlation between PND and inflammation. The incidence of PND in the Dex + Des group was lower than that in the Des group. The postoperative MMSE scores in the Dex + Des group were higher than those in the Des group (p = 0.032). The percentage of neutrophils in the Dex + Des group was significantly lower than that in the Des group on the first and third days after surgery (p = 0.007; p = 0.028). The MMSE scores on the first day after surgery were negatively correlated with the multiple changes in white blood counts and the percentage of neutrophils (r = −0.3038 and −0.3330). Dex combined with Des reduced the incidence of PND and reduced the postoperative inflammatory cell counts.

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